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妊娠期高血压与子痫前期:美国妇产科医师学会实践通报,第 222 号。

Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222.

出版信息

Obstet Gynecol. 2020 Jun;135(6):e237-e260. doi: 10.1097/AOG.0000000000003891.

Abstract

Hypertensive disorders of pregnancy constitute one of the leading causes of maternal and perinatal mortality worldwide. It has been estimated that preeclampsia complicates 2-8% of pregnancies globally (). In Latin America and the Caribbean, hypertensive disorders are responsible for almost 26% of maternal deaths, whereas in Africa and Asia they contribute to 9% of deaths. Although maternal mortality is much lower in high-income countries than in developing countries, 16% of maternal deaths can be attributed to hypertensive disorders (). In the United States, the rate of preeclampsia increased by 25% between 1987 and 2004 (). Moreover, in comparison with women giving birth in 1980, those giving birth in 2003 were at 6.7-fold increased risk of severe preeclampsia (). This complication is costly: one study reported that in 2012 in the United States, the estimated cost of preeclampsia within the first 12 months of delivery was $2.18 billion ($1.03 billion for women and $1.15 billion for infants), which was disproportionately borne by premature births (). This Practice Bulletin will provide guidelines for the diagnosis and management of gestational hypertension and preeclampsia.

摘要

妊娠高血压疾病是全球孕产妇和围产儿死亡的主要原因之一。据估计,全球范围内有 2-8%的妊娠合并先兆子痫()。在拉丁美洲和加勒比地区,妊娠高血压疾病导致近 26%的孕产妇死亡,而在非洲和亚洲,其导致的孕产妇死亡占 9%()。尽管在高收入国家,孕产妇死亡率远低于发展中国家,但仍有 16%的孕产妇死亡可归因于妊娠高血压疾病()。在美国,1987 年至 2004 年期间,先兆子痫的发病率上升了 25%()。此外,与 1980 年分娩的妇女相比,2003 年分娩的妇女患严重先兆子痫的风险增加了 6.7 倍()。这种并发症代价高昂:一项研究报告称,2012 年在美国,分娩后前 12 个月内先兆子痫的估计费用为 21.8 亿美元(女性为 10.3 亿美元,婴儿为 11.5 亿美元),其中早产儿的负担不成比例()。本实践公告将提供诊断和管理妊娠期高血压和先兆子痫的指南。

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