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子痫前期诊断与管理的最新进展

Recent advances in the diagnosis and management of pre-eclampsia.

作者信息

Hurrell Alice, Duhig Kate, Vandermolen Brooke, Shennan Andrew H

机构信息

Women's Health Academic Centre, King's College London, Westminster Bridge Road, London, SE1 7EH, UK.

出版信息

Fac Rev. 2020 Nov 16;9:10. doi: 10.12703/b/9-10. eCollection 2020.

Abstract

Pre-eclampsia is an elusive condition to diagnose and a complex disease to manage. There have been recent developments in prediction, prevention, diagnosis, and management. Risk modelling has been used to identify women at highest risk of developing pre-eclampsia as well as predicting maternal adverse outcomes in confirmed disease. New evidence has shown that aspirin prophylaxis significantly reduces early onset pre-eclampsia as well as preterm birth. The criteria for the diagnosis of pre-eclampsia are evolving, and proteinuria is no longer a pre-requisite to make a diagnosis. Angiogenic biomarker testing accelerates diagnosis as well as minimises adverse maternal outcomes and has been incorporated into national guidelines. Emerging evidence demonstrates that expedited delivery in late preterm pre-eclampsia may be protective against maternal adverse outcomes but increase the risk of neonatal unit admission. Both women and their offspring are at increased risk of long-term health complications following pre-eclampsia, and it is important that postnatal health is optimised. This article summarises recent developments in the field of pre-eclampsia research, evaluating the impact on clinical care for women at risk of, or with suspected or confirmed, pre-eclampsia.

摘要

子痫前期是一种难以诊断且管理复杂的病症。近年来在预测、预防、诊断和管理方面均有进展。风险建模已被用于识别发生子痫前期风险最高的女性,以及预测确诊疾病时的孕产妇不良结局。新证据表明,阿司匹林预防可显著降低早发型子痫前期以及早产的发生率。子痫前期的诊断标准正在不断演变,蛋白尿不再是诊断的必要条件。血管生成生物标志物检测可加速诊断并将孕产妇不良结局降至最低,且已被纳入国家指南。新出现的证据表明,晚期早产子痫前期的快速分娩可能对孕产妇不良结局具有保护作用,但会增加新生儿入住新生儿重症监护病房的风险。子痫前期后,女性及其后代发生长期健康并发症的风险均会增加,优化产后健康状况很重要。本文总结了子痫前期研究领域的最新进展,评估其对有子痫前期风险、疑似或确诊子痫前期的女性临床护理的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8722/7886065/0b814cc7093f/facrev-09-10-g001.jpg

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