Mikami Yukiko, Takagi Kenjiro, Itaya Yukiko, Ono Yoshihisa, Matsumura Hideyoshi, Takai Yasushi, Seki Hiroyuki
Department of Obstetrics and Gynecology, Saitama Medical University, Saitama Medical Center, Kawagoe-shi, Saitama, Japan.
J Obstet Gynaecol Res. 2014 Apr;40(4):919-25. doi: 10.1111/jog.12280. Epub 2014 Jan 15.
We examined the post-partum recovery course in patients with pre-eclampsia (PE) and gestational hypertension (GH) and evaluated the associated factors.
In a retrospective review of 145 patients with GH or PE who gave birth between 1 January 2008 and 30 October 2011 at our institution, there were 125 PE and 20 GH cases. Data collected included the gestational age at initial examination and delivery, delivery mode, time for normalization of blood pressure (BP), and time until resolution of proteinuria in PE patients. Comparisons were made between singleton and multiple pregnancies, onset (early, <32 weeks; late, ≥ 32 weeks) and fetal growth restriction in singleton pregnancies.
The mean interval for normalization of BP was 41.8 ± 29.4 days (median, 31.5). The mean interval for resolution of proteinuria was 30.0 ± 39.6 days (median, 27.0). Ninety percent of patients required 77 and 60 days to recover from hypertension and proteinuria, respectively. The time for BP normalization was longer in the early-onset group. The time for resolution of proteinuria was not affected by any factor examined.
A post-partum observation period of 12 weeks is acceptable for differentiating PE and GH from chronic hypertension or renal disease. GH severity did not affect the recovery period, but proteinuria severity did. Onset time was a factor influencing the recovery from PE and GH.
我们研究了子痫前期(PE)和妊娠期高血压(GH)患者的产后恢复过程,并评估了相关因素。
回顾性分析了2008年1月1日至2011年10月30日在我院分娩的145例GH或PE患者,其中PE患者125例,GH患者20例。收集的数据包括初次检查和分娩时的孕周、分娩方式、血压(BP)恢复正常的时间以及PE患者蛋白尿消失的时间。对单胎和多胎妊娠、单胎妊娠的发病时间(早发,<32周;晚发,≥32周)和胎儿生长受限情况进行了比较。
血压恢复正常的平均间隔时间为41.8±29.4天(中位数,31.5天)。蛋白尿消失的平均间隔时间为30.0±39.6天(中位数,27.0天)。90%的患者分别需要77天和60天从高血压和蛋白尿中恢复。早发组血压恢复正常的时间更长。蛋白尿消失的时间不受所检查的任何因素影响。
产后12周的观察期对于区分PE和GH与慢性高血压或肾病是可以接受的。GH的严重程度不影响恢复期,但蛋白尿的严重程度有影响。发病时间是影响PE和GH恢复的一个因素。