Foo L, Tay J, Lees C C, McEniery C M, Wilkinson I B
Department of Surgery & Cancer, Faculty of Medicine, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK,
Curr Hypertens Rep. 2015 May;17(5):36. doi: 10.1007/s11906-015-0545-1.
Hypertensive disorders of pregnancy affect approximately 5-10% of all maternities and are major contributors of maternal and neonatal morbidity and mortality worldwide. This group of disorders encompasses chronic hypertension, as well as conditions that arise de novo in pregnancy: gestational hypertension and pre-eclampsia. The latter group is thought to be part of the same continuum but with arbitrary division. Research into the aetiology of hypertension in pregnancy have largely been focused on pre-eclampsia, with a majority of studies exploring either pregnancy-associated factors such as placental-derived or immunologic responses to pregnancy tissue, or maternal constitutional factors such as cardiovascular health and endothelial dysfunction. The evidence base for the pathophysiology and progression of hypertensive disorders in pregnancy, particularly pre-eclampsia, is reviewed. Clinical algorithms and pharmacological agents for the management of hypertension in pregnancy are summarised, with a brief focus on post-partum considerations and long-term health implications. Novel therapeutic options for the management of pre-eclampsia are also explored.
妊娠期高血压疾病影响约5%-10%的所有孕产妇，是全球孕产妇和新生儿发病及死亡的主要原因。这组疾病包括慢性高血压以及妊娠期间新发的疾病：妊娠期高血压和子痫前期。后一组疾病被认为是同一连续体的一部分，但划分是人为的。对妊娠期高血压病因的研究主要集中在子痫前期，大多数研究探讨的是与妊娠相关的因素，如胎盘衍生因素或对妊娠组织的免疫反应，或母体体质因素，如心血管健康和内皮功能障碍。本文综述了妊娠期高血压疾病，尤其是子痫前期的病理生理学和进展的证据基础。总结了妊娠期高血压管理的临床算法和药物，简要关注产后注意事项和长期健康影响。还探讨了子痫前期管理的新治疗选择。
