Brown Catherine M, Garovic Vesna D
Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
Drugs. 2014 Mar;74(3):283-96. doi: 10.1007/s40265-014-0187-7.
Hypertensive disorders represent major causes of pregnancy-related maternal mortality worldwide. Similar to the non-pregnant population, hypertension is the most common medical disorder encountered during pregnancy and is estimated to occur in about 6-8 % of pregnancies. A recent report highlighted hypertensive disorders as one of the major causes of pregnancy-related maternal deaths in the USA, accounting for 579 (12.3 %) of the 4,693 maternal deaths that occurred between 1998 and 2005. In low-income and middle-income countries, preeclampsia and its convulsive form, eclampsia, are associated with 10-15 % of direct maternal deaths. The optimal timing and choice of therapy for hypertensive pregnancy disorders involves carefully weighing the risk-versus-benefit ratio for each individual patient, with an overall goal of improving maternal and fetal outcomes. In this review, we have compared and contrasted the recommendations from different treatment guidelines and outlined some newer perspectives on management. We aim to provide a clinically oriented guide to the drug treatment of hypertension in pregnancy.
高血压疾病是全球与妊娠相关的孕产妇死亡的主要原因。与非妊娠人群相似,高血压是孕期最常见的内科疾病,估计约6-8%的妊娠会出现高血压。最近一份报告强调,在美国,高血压疾病是与妊娠相关的孕产妇死亡的主要原因之一,在1998年至2005年期间发生的4693例孕产妇死亡中,有579例(12.3%)是由高血压疾病导致的。在低收入和中等收入国家,子痫前期及其惊厥形式子痫,与10-15%的孕产妇直接死亡有关。高血压妊娠疾病治疗的最佳时机和治疗方法的选择需要仔细权衡每个患者的风险效益比,总体目标是改善母婴结局。在本综述中,我们比较并对比了不同治疗指南的建议,并概述了一些新的管理观点。我们旨在提供一份以临床为导向的妊娠期高血压药物治疗指南。