Clark Shannon M, Dunn Holly E, Hankins Gary D V
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, The University of Texas Medical Branch-Galveston, 301 University Blvd., Route 0587, Galveston, TX 77550.
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, The University of Texas Medical Branch-Galveston, 301 University Blvd., Route 0587, Galveston, TX 77550.
Semin Perinatol. 2015 Nov;39(7):548-55. doi: 10.1053/j.semperi.2015.08.011. Epub 2015 Sep 4.
Hypertension is the most commonly encountered medical condition in pregnancy, contributing significantly to maternal and perinatal morbidity and mortality. Mild to moderate hypertension in pregnancy is defined as systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-109 mmHg (7-9% of pregnancies). When treating hypertension in pregnancy, not only do physiologic changes of pregnancy have an effect on the pharmacokinetics and pharmacodynamics of the drugs used, but the pathophysiology of hypertensive disorders of pregnancy also have an effect. To date, evidence is lacking on the pharmacokinetics and pharmacodynamics of commonly used antihypertensive drugs, which often times leads to suboptimal treatment of hypertensive pregnant women. When considering which agents to use for treatment of mild to moderate hypertension, specifically in gestational and chronic hypertension, oral labetalol and nifedipine are valid options. An overview of the profile for use, safety, and current pharmacokinetic data for each agent is presented here.
高血压是妊娠期最常见的病症,对孕产妇和围产期发病率及死亡率有重大影响。妊娠期轻度至中度高血压定义为收缩压140 - 159 mmHg或舒张压90 - 109 mmHg(占妊娠的7 - 9%)。在治疗妊娠期高血压时,不仅妊娠的生理变化会影响所用药物的药代动力学和药效学,妊娠期高血压疾病的病理生理学也会产生影响。迄今为止,缺乏常用降压药物的药代动力学和药效学证据,这常常导致对高血压孕妇的治疗效果欠佳。在考虑使用哪些药物治疗轻度至中度高血压时,特别是在妊娠高血压和慢性高血压中,口服拉贝洛尔和硝苯地平是有效的选择。本文概述了每种药物的使用情况、安全性和当前药代动力学数据。