Fukuya Fernanda Ayumi, Nemalapuri Kiranmayee S, Jabeen Afshan, Moreira de Marchi Apolaro Ana Vitoria, Venkatesan Hansika, Peter Anjana K, Chen Yu Min Krystal, Rehman Rabia, Mary Ayodele Ifeoluwa, Pathan Nahila A, Ali Ramsha
Internal Medicine, University of Mogi das Cruzes (UMC), Mogi das Cruzes, BRA.
Medicine, Massachusetts College of Pharmacy and Health Sciences, Boston, USA.
Cureus. 2025 May 29;17(5):e85025. doi: 10.7759/cureus.85025. eCollection 2025 May.
This narrative review aims to analyze the existing data on the diagnosis, risk factors, treatment, prevention, and long-term implications of hypertension in pregnancy. An extensive search was conducted using the PubMed database to identify relevant studies from the past 10 years. These studies indicate that hypertension during pregnancy is a leading cause of maternal and infant mortality in the United States. Early identification of high-risk individuals, along with improved prenatal screening and early intervention strategies, has been shown to enhance maternal care. Home blood pressure monitoring (HBPM) is a simple and reliable method for measuring an individual's blood pressure (BP). Hypertensive disorders of pregnancy can be predicted using biomarkers such as alpha-fetoprotein, free beta-human chorionic gonadotropin (hCG), and D-dimer in blood samples. Additionally, the soluble fms-like tyrosine kinase 1-to-placental growth factor (sFLT-1/PLGF) ratio is a key biomarker for diagnosing early- and late-onset preeclampsia. The administration of antihypertensive medications for mild-to-moderate hypertension is beneficial in preventing adverse maternal and fetal outcomes. First-line (such as labetalol) and second-line (including nifedipine, methyldopa, and hydrochlorothiazides) drugs are commonly used. Aspirin may be used prophylactically in cases of chronic hypertension to prevent preeclampsia. In addition to this, planned delivery at 38 weeks of gestation has been associated with a reduction in adverse outcomes for both mother and fetus. Regular BP monitoring, smoking cessation, and adherence to a healthy diet and lifestyle can help reduce the long-term complications of hypertension during pregnancy.
本叙述性综述旨在分析关于妊娠期高血压的诊断、危险因素、治疗、预防及长期影响的现有数据。利用PubMed数据库进行了广泛检索,以确定过去10年的相关研究。这些研究表明,妊娠期高血压是美国孕产妇和婴儿死亡的主要原因。已证明,早期识别高危个体,以及改进产前筛查和早期干预策略,可提高孕产妇护理水平。家庭血压监测(HBPM)是测量个体血压(BP)的一种简单可靠的方法。妊娠高血压疾病可通过血液样本中的生物标志物如甲胎蛋白、游离β-人绒毛膜促性腺激素(hCG)和D-二聚体进行预测。此外,可溶性fms样酪氨酸激酶1与胎盘生长因子(sFLT-1/PLGF)的比值是诊断早发型和晚发型子痫前期的关键生物标志物。对于轻度至中度高血压患者,使用抗高血压药物有利于预防孕产妇和胎儿的不良结局。常用一线药物(如拉贝洛尔)和二线药物(包括硝苯地平、甲基多巴和氢氯噻嗪)。对于慢性高血压患者,阿司匹林可用于预防子痫前期。除此之外,妊娠38周时计划分娩与降低母亲和胎儿的不良结局有关。定期监测血压、戒烟以及坚持健康的饮食和生活方式有助于减少妊娠期高血压的长期并发症。