Curet L B, Olson R W
Obstet Gynecol. 1979 Mar;53(3):336-40.
Sixty-six patients with chronic hypertension were cared for during a total of 72 pregnancies. Patients were treated at home primarily by greater than or equal to 4 hours of bed rest daily in the left recumbent position. Only patients whose diastolic blood pressures remained greater than 110 mmHg were treated with hydralazine (Apresoline, Ciba). With this plan of treatment there were only 3 perinatal deaths for an uncorrected perinatal mortality of 4.1% (1.4% corrected). Twenty-nine percent of the patients had babies that were small for gestational age, 13.8% had positive oxytocin challenge tests, and 36.8% developed superimposed preeclampsia. When compared with the outcome of previous pregnancies, the program of bed rest lowered perinatal mortality from 16.8 to 8.8%. Thus, it is suggested that bed rest together with the avoidance of diuretics and the judicious use of hydralazine results in the most favorable fetal outcome.
66例慢性高血压患者共经历了72次妊娠。患者主要在家接受治疗，每天以左侧卧位卧床休息至少4小时。只有舒张压持续高于110 mmHg的患者才使用肼屈嗪（阿普利素灵，汽巴公司生产）治疗。按照此治疗方案，围产期死亡仅3例，未校正的围产期死亡率为4.1%（校正后为1.4%）。29%的患者分娩的婴儿小于孕周，13.8%的患者催产素激惹试验呈阳性，36.8%的患者并发子痫前期。与既往妊娠结局相比，卧床休息方案使围产期死亡率从16.8%降至8.8%。因此，建议卧床休息、避免使用利尿剂以及谨慎使用肼屈嗪可带来最有利的胎儿结局。
