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妊娠期继发性高血压

Secondary Hypertension in Pregnancy.

作者信息

Malha Line, August Phyllis

机构信息

New York University School of Medicine, 550 First Avenue-OBV A600, New York, NY, 10016, USA,

出版信息

Curr Hypertens Rep. 2015 Jul;17(7):53. doi: 10.1007/s11906-015-0563-z.

Abstract

Hypertension is a common medical complication of pregnancy. Although 75-80 % of women with preexisting essential hypertension will have uncomplicated pregnancies, the presence of secondary forms of hypertension adds considerably to both maternal and fetal morbidity and mortality. Renovascular hypertension, pheochromocytoma, and Cushing's syndrome in particular are associated with accelerating hypertension, superimposed preeclampsia, preterm delivery, and fetal loss. Primary aldosteronism is a more heterogeneous disorder; there are well-documented cases where blood pressure and hypokalemia are improved during pregnancy due to elevated levels of progesterone. However, superimposed preeclampsia, worsening hypertension, and early delivery are also reported. When possible, secondary forms of hypertension should be diagnosed and treated prior to conception in order to avoid these complications.

摘要

高血压是妊娠期常见的医学并发症。虽然75% - 80%患有原发性高血压的孕妇妊娠过程顺利,但继发性高血压的存在会显著增加母婴的发病率和死亡率。特别是肾血管性高血压、嗜铬细胞瘤和库欣综合征与高血压加速、子痫前期叠加、早产和胎儿丢失有关。原发性醛固酮增多症是一种更为异质性的疾病;有充分记录的病例显示,由于孕酮水平升高,孕期血压和低钾血症会得到改善。然而,也有子痫前期叠加、高血压恶化和早产的报道。可能的话,继发性高血压应在受孕前进行诊断和治疗,以避免这些并发症。

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