Pritzker School of Medicine, University of Chicago, IL, United States.
Department of Obstetrics and Gynecology, University of Chicago, IL, United States; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
Pregnancy Hypertens. 2019 Jul;17:253-260. doi: 10.1016/j.preghy.2019.07.007. Epub 2019 Jul 23.
To describe patient outcomes, management of hypertensive disorders of pregnancy, and evaluate provider knowledge of practice guidelines at a tertiary care center in urban China.
Retrospective chart review of patients admitted between September 2017 and March 2018 with a diagnosis of any hypertensive disorder at Zhongnan Hospital of Wuhan University Medical Center in China. Healthcare providers including physicians, midwives, nurses and medical students were surveyed. Patient outcomes were compared to those at the University of Chicago, USA.
Prevalence of hypertensive disorders of pregnancy, comparative rates of medication administration, mode of delivery, and other pregnancy characteristics were abstracted. Responses regarding definitions, treatment and outcomes of hypertension were analyzed using survey data.
Among 2834 patients, the prevalence of hypertensive disorders at the Zhongnan Hospital was 7.1%, with a 6.4% prevalence of preeclampsia. Compared to hypertensive women from the University of Chicago, hypertensive patients at Zhongnan Hospital were more likely to be older and weigh less but had higher rates of antihypertensive drug administration and delivery via cesarean section. Infants born at Zhongnan Hospital were less likely to be admitted to the neonatal intensive care unit. Survey respondents demonstrated poor knowledge of preeclampsia diagnoses and first line treatments for severe hypertension in pregnancy.
Although several clinical characteristics of preeclampsia were similar between hospitals, the rates of cesarean section were higher in China. Provider knowledge was most lacking in areas about diagnostic criteria and medication use for preeclampsia. Future studies are needed to explore these differences.
描述中国城市一家三级保健中心妊娠高血压疾病患者的结局、管理方法，并评估医务人员对实践指南的了解程度。
对 2017 年 9 月至 2018 年 3 月期间在中国武汉大学中南医院住院且诊断为任何类型高血压疾病的患者进行回顾性病历分析。调查了包括医生、助产士、护士和医学生在内的医务人员。将患者结局与美国芝加哥大学进行比较。
妊娠高血压疾病的患病率，药物治疗、分娩方式等妊娠特征的比较率。使用调查数据分析有关高血压定义、治疗和结局的回答。
在 2834 例患者中，中南医院妊娠高血压疾病的患病率为 7.1%，其中子痫前期的患病率为 6.4%。与来自芝加哥大学的高血压女性相比，中南医院的高血压患者年龄更大、体重更轻，但降压药物治疗和剖宫产率更高。在中南医院分娩的婴儿更不可能入住新生儿重症监护病房。调查对象对子痫前期的诊断和妊娠重度高血压的一线治疗方案知识匮乏。
尽管两家医院子痫前期的一些临床特征相似，但中国的剖宫产率更高。医务人员在子痫前期的诊断标准和药物使用方面知识最欠缺。需要进一步研究来探讨这些差异。
