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妊娠期高血压疾病:当前实践综述

Hypertensive Disorders in Pregnancy Current Practice Review.

作者信息

Turner Kim, Hameed Afshan B

机构信息

University of Southern California - Global Health Los Angeles, California, CA 90012. United States.

Department of Obstetrics, University of California Irvine - California, CA 90012. United States.

出版信息

Curr Hypertens Rev. 2017;13(2):80-88. doi: 10.2174/1573402113666170529110024.

Abstract

BACKGROUND

Hypertensive disorders (preeclampsia, eclampsia, gestational hypertension, and chronic hypertension with superimposed preeclampsia) complicate 3-5% of all pregnancies and are a significant cause of maternal mortality and morbidity. Preeclampsia is a multi-system disorder characterised by new onset hypertension after the 20th week of pregnancy with proteinuria. Proteinuria is defined as 300 mg or more of protein in a 24-hour urine collection or a protein: creatinine ratio of 0.3 mg/dL using a spot urine specimen. Hypertensive disorders have a complex pathophysiology that results from abnormal placen- tation and a maternal response that develops into a clinicalsyndrome for which there is no single test or "cure". In high income countries, low rates of maternal mortality from hy- pertensive disease in pregnancy illustrate the importance of pregnant women being able to readily access antenatal care.

CONCLUSION

There remains the need to develop evidence-based clinical guidelines for detection, prophylaxis and management worldwide.

摘要

背景

高血压疾病(先兆子痫、子痫、妊娠期高血压以及慢性高血压并发先兆子痫)使3%至5%的妊娠复杂化,是孕产妇死亡和发病的重要原因。先兆子痫是一种多系统疾病,其特征为妊娠20周后新发高血压并伴有蛋白尿。蛋白尿的定义为24小时尿蛋白含量300毫克或更多,或采用随机尿标本时尿蛋白与肌酐比值为0.3毫克/分升。高血压疾病具有复杂的病理生理学,由胎盘异常着床以及母体反应导致,进而发展为一种临床综合征,对此并无单一检测方法或“治愈手段”。在高收入国家,妊娠高血压疾病导致的孕产妇死亡率较低,这表明孕妇能够方便地获得产前护理至关重要。

结论

全球仍需制定基于证据的临床检测、预防和管理指南。

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