Lubbe W F, Hodge J V, Kellaway G S
N Z Med J. 1982 Jan 13;95(699):1-5.
A series of 184 pregnancies in 161 hypertensive women was classified according to the regimen of antihypertensive treatment used during pregnancy. In 72 pregnancies management was with bed rest alone, attaining a mean gestation of 37.8 +/- 0.4 weeks, a mean birthweight of 2941 +/- 97 g with 38 percent of infants below the 25th percentile. Late deterioration of hypertension with development of proteinuria occurred in 16.6 percent with fetal mortality of 6.9 percent. Antihypertensive therapy involved methyldopa, thiazide diuretics, sympathetic ganglion blockers, hydralazine, beta-adrenergic blockers and the combination of oxprenolol and prazosin. Fetal growth was compared in pregnancies that reached term on the various regimens. Significantly better growth was achieved where debrisoquine plus a thiazide were used (3617 +/- 113 g in six subjects) and oxprenolol/prazosin (3411 +/- 72 g in 14 subjects) compared to 11 comparably hypertensive patients on bed rest alone (2975 +/-87 g). Therapy with the ganglion blocker plus thiazide was complicated by the deterioration of hypertension with proteinuria in 37.2 percent of women; this did not occur in patients receiving oxprenolol/prazosin. Maternal age had no effect on fetal growth, but smoking more than 10 cigarettes per day caused significant growth retardation.
161名高血压女性的184次妊娠根据孕期使用的降压治疗方案进行了分类。72次妊娠仅采用卧床休息管理，平均孕周为37.8±0.4周，平均出生体重为2941±97克，38%的婴儿低于第25百分位数。16.6%的患者出现高血压晚期恶化并伴有蛋白尿，胎儿死亡率为6.9%。降压治疗包括甲基多巴、噻嗪类利尿剂、交感神经节阻滞剂、肼屈嗪、β-肾上腺素能阻滞剂以及氧烯洛尔和哌唑嗪的联合使用。对采用不同方案足月分娩的妊娠胎儿生长情况进行了比较。与11名仅卧床休息的类似高血压患者（2975±87克）相比，使用地布喹加噻嗪类药物（6名受试者为3617±113克）和氧烯洛尔/哌唑嗪（14名受试者为3411±72克）的患者胎儿生长情况明显更好。37.2%接受神经节阻滞剂加噻嗪类药物治疗的女性出现高血压伴蛋白尿恶化；接受氧烯洛尔/哌唑嗪治疗的患者未出现这种情况。母亲年龄对胎儿生长没有影响，但每天吸烟超过10支会导致明显的生长迟缓。
