妊娠期轻度慢性高血压的现行治疗指南及降压治疗

T. Ahn, J. Hwang
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引用次数: 0

摘要

高达5%的孕妇患有慢性高血压,这与妊娠结局不良有关,并伴有出血,被认为是孕产妇发病和死亡的主要原因之一。合并子痫前期、剖宫产、早产、出生体重小于2500 g、新生儿住院和围产期死亡的发生率在慢性高血压女性中较高。妊娠期收缩压140-159 mmHg或舒张压90-109 mmHg被认为患有轻中度慢性高血压。妊娠期血压管理是一个非常重要的问题,直接关系到胎儿的生长和孕产妇的健康。许多研究报告称,妊娠期降压治疗可使所有类型高血压疾病中严重高血压的发病率减半。然而,怀孕期间最佳血压管理目标的指导方针仍不清楚。这是因为降低血压对母亲的好处是不确定的,并且由于子宫胎盘血流减少的可能性,存在胎儿疾病的风险。根据最近发布的一项CHAP(慢性高血压和妊娠)随机对照试验,本综述的目的是总结目前对患有轻中度慢性高血压的妊娠女性的建议。
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Current Treatment Guidelines and Antihypertensive Therapy of Mild Chronic Hypertension During Pregnancy
Up to 5% of pregnant females experience chronic hypertension, which is linked to poor pregnancy outcomes, and along with hemorrhage, is considered one of the main causes of maternal morbidity and mortality. The combined occurrence of preeclampsia, cesarean sections, preterm birth, birth weight less than 2,500 g, neonatal unit admission, and perinatal death was higher in females with chronic hypertension. Pregnancy with systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-109 mmHg was considered to have mild-to-moderate chronic hypertension. Blood pressure management during pregnancy is a very important issue and is directly related to fetal growth and maternal health. Many studies have reported that antihypertensive therapy during pregnancy halves the incidence of severe hypertension in all types of hypertensive diseases. However, guidelines for optimal blood pressure management goals during pregnancy remain unclear. This is because the benefits to the mother from lowering blood pressure are uncertain, and there is a risk of fetal disorders due to the possibility of reduced uteroplacental blood flow. In light of a recently released CHAP (Chronic Hypertension and Pregnancy) randomized controlled trial, the purpose of this review was to provide a summary of the current recommendations for pregnant females with mild-to-moderate chronic hypertension.
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