Upadya Madhusudan, Rao Sumesh T
Department of Anaesthesia, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India.
Indian J Anaesth. 2018 Sep;62(9):675-681. doi: 10.4103/ija.IJA_475_18.
Hypertensive disorders of pregnancy (HDP) remain among the most significant and intriguing unsolved problems in obstetrics. In India, the prevalence of HDP was 7.8% with pre-eclampsia in 5.4% of the study population. The anaesthetic problems in HDP may be due to the effects on the cardiovascular, respiratory, neurologic, renal, haematologic, hepatic and uteroplacental systems. The basic management objectives should be facilitating the birth of an infant who subsequently thrives and completes restoration of health to the mother, or the termination of pregnancy with the least possible trauma to mother and foetus in severe pre-eclampsia. This comprises obstetric management, adequate foetal surveillance, antihypertensive management, anticonvulsant therapy, safe analgesia for labour and management of anaesthesia for delivery.
妊娠高血压疾病(HDP)仍然是产科领域最重要且最具挑战性的未解难题之一。在印度,HDP的患病率为7.8%,其中5.4%的研究人群患有先兆子痫。HDP中的麻醉问题可能是由于其对心血管、呼吸、神经、肾脏、血液、肝脏及子宫胎盘系统的影响。基本的管理目标应是促使婴儿顺利出生并茁壮成长,同时使母亲完全恢复健康,或者在重度先兆子痫的情况下,以对母亲和胎儿造成最小创伤的方式终止妊娠。这包括产科管理、充分的胎儿监测、降压管理、抗惊厥治疗、安全的分娩镇痛以及分娩麻醉管理。