Nakanishi Sayuri, Aoki Shigeru, Nagashima Ami, Seki Kazuo
Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
Pregnancy Hypertens. 2017 Jan;7:39-43. doi: 10.1016/j.preghy.2017.01.001. Epub 2017 Jan 10.
To investigate the incidence and pregnancy outcomes of superimposed preeclampsia (PE) with or without proteinuria among women with chronic hypertension.
This retrospective study included 142 women with essential hypertension diagnosed at ⩽20weeks of gestation, managed at a tertiary center. They were divided into three groups (non-PE, PE with proteinuria, and PE without proteinuria) to compare pregnancy outcomes. The non-PE group was further divided into two subgroups (controlled and uncontrolled hypertension).
There were 87 women in the non-PE group, 47 in the PE with proteinuria group, and 8 in the PE without proteinuria group. Median gestational age at delivery was 38.7weeks in the non-PE group, 30.4 in the PE with proteinuria group, and 28.4 in the PE without proteinuria group. In three of the women in the PE without proteinuria group, the diagnostic criteria were fulfilled by liver involvement (complicated by thrombocytopenia in one woman). The remaining five women had uteroplacental dysfunction. The 87 women in the non-PE group were divided into a controlled hypertension subgroup of 75 women and uncontrolled hypertension subgroup of 12. The median gestational age at delivery was 39.1weeks in the controlled HT subgroup and 34.1weeks in the uncontrolled hypertension subgroup. The pregnancy outcomes were significantly poorer in the latter group.
Pregnancy outcomes were unfavorable in both the PE without proteinuria and PE with proteinuria groups. Women with non-PE uncontrolled hypertension also had poor pregnancy outcomes, although their outcomes were better than those of women with PE.
探讨慢性高血压孕妇并发或不并发蛋白尿的叠加先兆子痫（PE）的发生率及妊娠结局。
这项回顾性研究纳入了142例在妊娠20周及以前于三级中心确诊为原发性高血压的孕妇。她们被分为三组（非PE组、有蛋白尿的PE组和无蛋白尿的PE组）以比较妊娠结局。非PE组进一步分为两个亚组（血压控制组和未控制组）。
非PE组有87例孕妇，有蛋白尿的PE组有47例，无蛋白尿的PE组有8例。非PE组分娩时的中位孕周为38.7周，有蛋白尿的PE组为30.4周，无蛋白尿的PE组为28.4周。在无蛋白尿的PE组中的3例孕妇中，诊断标准是由肝脏受累满足的（其中1例并发血小板减少症）。其余5例孕妇有子宫胎盘功能障碍。非PE组的87例孕妇被分为血压控制亚组的75例和未控制高血压亚组的12例。血压控制亚组分娩时的中位孕周为39.1周，未控制高血压亚组为34.1周。后一组的妊娠结局明显较差。
无蛋白尿的PE组和有蛋白尿的PE组的妊娠结局均不理想。非PE未控制高血压的孕妇妊娠结局也较差，尽管其结局优于PE孕妇。
