Meschede G, Löhr J, Mühlenstedt D
Geburtshilfe Frauenheilkd. 1983 Dec;43(12):759-61. doi: 10.1055/s-2008-1036747.
Diuretics potentiate existing hypovolaemia and hämoconcentration in patients suffering from toxemia of pregnancy. This effect also applies to the fetus. A case is presented of an intrauterine spontaneous thrombosis in the inferior vena cava and its tributaries in a fetus with resulting perinatal death during long-term diuretic therapy because of edema in the mother in the third trimester. Basing on this example, the present state of assessment and necessity of treatment of the symptom "edema" in late pregnancy is discussed, with the conclusion that administration of diuretics, if it becomes necessary in a life-threatening state of the pregnant mother (pulmonary edema or oliguria in pre-eclampsia or eclampsia) is indicated only with monitoring of the hematocrit and central venous pressure.
利尿剂会加重妊娠中毒症患者已有的血容量过低和血液浓缩情况。这种影响同样适用于胎儿。本文介绍了一例因孕晚期母亲水肿接受长期利尿治疗的胎儿，其下腔静脉及其分支发生子宫内自发性血栓形成，并导致围产期死亡。基于此案例，讨论了妊娠晚期“水肿”症状的评估现状和治疗必要性，得出的结论是，在危及孕妇生命的状态（先兆子痫或子痫中的肺水肿或少尿）下，如果有必要使用利尿剂，仅应在监测血细胞比容和中心静脉压的情况下进行。
