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子痫前期和子痫:加强检测与治疗以降低发病率。

Preeclampsia and eclampsia: Enhanced detection and treatment for morbidity reduction.

作者信息

Kovacheva Vesela P, Venkatachalam Shakthi, Pfister Claire, Anwer Tooba

机构信息

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1, Boston, MA, 02115, USA.

UCT Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Main Road, Observatory, Cape Town, Postal code 7935, South Africa.

出版信息

Best Pract Res Clin Anaesthesiol. 2024 Sep;38(3):246-256. doi: 10.1016/j.bpa.2024.11.001. Epub 2024 Nov 19.

Abstract

Preeclampsia is a life-threatening complication that develops in 2-8% of pregnancies. It is characterized by elevated blood pressure after 20 weeks of gestation and may progress to multiorgan dysfunction, leading to severe maternal and fetal morbidity and mortality. The only definitive treatment is delivery, and efforts are focused on early risk prediction, surveillance, and severity mitigation. Anesthesiologists, as part of the interdisciplinary team, should evaluate patients early in labor in order to optimize cardiovascular, pulmonary, and coagulation status. Neuraxial techniques are safe in the absence of coagulopathy and aid avoidance of general anesthesia, which is associated with high risk in these patients. This review aims to provide anaesthesiologists with a comprehensive update on the latest strategies and evidence-based practices for managing preeclampsia, with an emphasis on perioperative care.

摘要

子痫前期是一种危及生命的并发症,在2%至8%的妊娠中发生。其特征是妊娠20周后血压升高,并可能进展为多器官功能障碍,导致严重的母婴发病和死亡。唯一确定的治疗方法是分娩,工作重点是早期风险预测、监测和减轻严重程度。作为跨学科团队的一员,麻醉医生应在分娩早期对患者进行评估,以优化心血管、肺部和凝血状态。在没有凝血病的情况下,神经轴技术是安全的,有助于避免全身麻醉,全身麻醉在这些患者中具有高风险。本综述旨在为麻醉医生提供关于管理子痫前期的最新策略和循证实践的全面更新,重点是围手术期护理。

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Preeclampsia and eclampsia: Enhanced detection and treatment for morbidity reduction.子痫前期和子痫:加强检测与治疗以降低发病率。
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Postpartum Home Blood Pressure Monitoring: A Systematic Review.产后家庭血压监测:系统评价。
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Nat Med. 2023 Jun;29(6):1540-1549. doi: 10.1038/s41591-023-02374-9. Epub 2023 May 29.

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