Amro Farah H, Moussa Hind N, Ashimi Olaide A, Sibai Baha M
a Department of Obstetrics, Gynecology and Reproductive Sciences , The University of Texas Health Science Center at Houston , Houston , TX , USA.
b Department of Obstetrics, Gynecology and Reproductive Sciences , Division of Maternal Fetal Medicine , Houston , TX , USA.
Expert Opin Drug Saf. 2016 Dec;15(12):1635-1642. doi: 10.1080/14740338.2016.1237500. Epub 2016 Oct 11.
Hypertensive disorders have become increasingly prevalent and complicate an increasing number of pregnancies. Therefore it is essential that the medications used to treat these disorders be well understood. Furthermore the management is complicated by special consideration needed for the physiologic changes of pregnancy as well as the consideration for possible adverse fetal effects. Areas covered: We performed a review of the scientific literature of medications used to treat hypertensive disorders in pregnancy. We reviewed the guidelines used by different societies all over the world. We also discussed the pharmacodynamics, pharmacokinetics and possible adverse effects relating to the antihypertensive medications. Finally, we discussed the long-term maternal implications of these diseases. Expert opinion: Overall, we encourage a step-wise approach to treating hypertensive disorders of pregnancy. While making sure to max out the use of one medications prior to shifting to another. Also, it is imperative not to be aggressive with treatment due to risk of compromising utero-placental blood flow. There is research currently involving biomarkers, nano-medicine and the placenta project with hopes of developing new targeted medications with a good fetal safety profile.
高血压疾病在孕期愈发普遍，使越来越多的妊娠出现并发症。因此，必须充分了解用于治疗这些疾病的药物。此外，由于孕期生理变化需要特别考虑，以及对可能的胎儿不良影响的考量，管理变得复杂。涵盖领域：我们对用于治疗孕期高血压疾病的药物的科学文献进行了综述。我们回顾了世界各地不同学会使用的指南。我们还讨论了与抗高血压药物相关的药效学、药代动力学及可能的不良反应。最后，我们讨论了这些疾病对母亲的长期影响。专家观点：总体而言，我们鼓励采用逐步治疗孕期高血压疾病的方法。在换用另一种药物之前，务必充分使用一种药物。此外，由于存在损害子宫胎盘血流的风险，治疗时切勿激进。目前有涉及生物标志物、纳米医学和胎盘项目的研究，希望开发出具有良好胎儿安全性的新型靶向药物。
