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非重度妊娠高血压疾病与口服抗高血压药物:支持使用的观点

Nonsevere hypertensive disorders of pregnancy and oral antihypertensive medications: an argument in favor of use.

作者信息

Martinez-King Lorena Carolina, Savitsky Leah M, Rose Sherill, Albright Catherine

机构信息

Maternal Fetal Medicine Fellow, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington Medical Center, Seattle, WA (Martinez-King, Savitsky, Rose and Albright).

Maternal Fetal Medicine Fellow, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington Medical Center, Seattle, WA (Martinez-King, Savitsky, Rose and Albright).

出版信息

Am J Obstet Gynecol MFM. 2025 Mar;7(1S):101561. doi: 10.1016/j.ajogmf.2024.101561. Epub 2024 Nov 26.

Abstract

Hypertensive disorders of pregnancy are a common complication of pregnancy and a major contributor to both immediate and long-term morbidity and mortality. Recent data support the treatment of chronic hypertension during pregnancy to a blood pressure goal of <140/90 mmHg. Treatment of severe range blood pressures (≥160/110 mmHg) in the setting of gestational hypertension is recommended to prevent severe morbidity and mortality; however, there remains clinical equipoise regarding treatment of gestational hypertension with blood pressures ≥140/90 but <160/110. While there is limited data to support the treatment of gestational hypertension, we believe that treatment of gestational hypertension to a blood pressure of <140/90, similar to the recommendations for chronic hypertension, will lead to a reduction in severe maternal and neonatal morbidity and mortality related to hypertensive disorders of pregnancy. In this expert review, we summarize the available data regarding the treatment of gestational hypertension and offer recommendations for the treatment of gestational hypertension based on our clinical experience.

摘要

妊娠期高血压疾病是妊娠期常见的并发症,是导致近期和远期发病及死亡的主要原因。近期数据支持在孕期将慢性高血压治疗至血压目标值<140/90 mmHg。对于妊娠期高血压,建议治疗严重范围的血压(≥160/110 mmHg)以预防严重发病和死亡;然而,对于血压≥140/90但<160/110的妊娠期高血压的治疗,临床上仍存在权衡。虽然支持治疗妊娠期高血压的数据有限,但我们认为,将妊娠期高血压治疗至血压<140/90,类似于慢性高血压的治疗建议,将降低与妊娠期高血压疾病相关的严重孕产妇和新生儿发病及死亡。在本专家综述中,我们总结了关于妊娠期高血压治疗的现有数据,并根据我们的临床经验提供妊娠期高血压治疗建议。

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本文引用的文献

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Gestational hypertension and "severe" disease: time for a change.妊娠期高血压与“重度”疾病:变革之时。
Am J Obstet Gynecol. 2023 May;228(5):547-552. doi: 10.1016/j.ajog.2022.11.1280. Epub 2022 Nov 14.
8
Treatment for Mild Chronic Hypertension during Pregnancy.妊娠期轻度慢性高血压的治疗。
N Engl J Med. 2022 May 12;386(19):1781-1792. doi: 10.1056/NEJMoa2201295. Epub 2022 Apr 2.
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Indication Creep of Antenatal Late Preterm Steroids.产前晚期早产儿类固醇的适应证扩展。
Am J Perinatol. 2022 Aug;39(11):1159-1165. doi: 10.1055/a-1785-9290. Epub 2022 Mar 2.

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