Гипертензивные нарушения беременности. Материнские и эмбриональные результаты лабораторных исследований

TI: The hypertensive disorders of pregnancy.

TI: гипертензивные нарушения беременности.

AU: Broughton-Pipkin-F

AD: Department of Obstetrics and Gynaecology, University Hospital, Queen's Medical Centre, Nottingham.

SO: BMJ. 1995 Sep 2; 311(7005): 609-13

MESH: Hypertension-diagnosis; Hypertension-etiology; Hypertension-therapy; Pre-Eclampsia-diagnosis; Pre-Eclampsia-etiology; Pre-Eclampsia-therapy; Pregnancy-; Pregnancy-Complications,-Cardiovascular-diagnosis; Pregnancy-Complications,-Cardiovascular-etiology; Pregnancy-Complications,-Cardiovascular-therapy

MESH: *Hypertension-; *Pregnancy-Complications,-Cardiovascular

TI: New-onset hypertension in the pregnant patient.

TI: Выявленная впервые артериальная гипертензия в беременном пациенте.

AU: Magann-EF; Martin-JN Jr

AD: Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.

SO: Obstet-Gynecol-Clin-North-Am. 1995 Mar; 22(1): 157-71

AB: The new onset of hypertension in pregnancy most often reflects preeclampsia, underlying chronic hypertension, chronic hypertension with superimposed preeclampsia, or gestational hypertension, and less commonly is due to substance abuse or any of several rare conditions. The term "pregnancy-induced hypertension" applies to all of these categories, but because it does not adequately and specifically define the patient's condition, its use therefore is discouraged. Attention to accurate identification of the specific type of "pregnancy-induced hypertension" is important since treatment varies depending on the diagnosis and the stage of pregnancy from observation with gestational hypertension to active intervention in the patient with chronic hypertension and superimposed preeclampsia. Both perinatal and maternal outcomes are dependent also on the categorization of the hypertensive disorders of pregnancy. Efforts to selectively identify, correctly diagnose, and optimally treat each hypertensive mother should help to achieve the best possible outcome with the least maternal risk.

: Новое начало артериальной гипертензии в беременности наиболее часто отражает преэклампсию, основную хроническую артериальную гипертензию, хроническая артериальная гипертензия с добавленной преэклампсией, или гестациозной артериальной гипертензией, и менее обычно - вследствие токсикомания или любое из нескольких редких условий(состояний). Срок(термин) " вынужденный беременностью артериальную гипертензию " обращается весь из этих категорий, но потому что это делает не адекватно и определенно определяет условие(состояние) пациента, его использованию поэтому препятствуют. Внимание к точной идентификации определенного типа " вынужденная беременностью артериальная гипертензия " является важным, так как обработка(лечение) изменяется в зависимости от диагноза и стадии беременности от наблюдения с гестациозной артериальной гипертензией к активному вмешательству в пациенте с хронической артериальной гипертензией и добавленной преэклампсией. И перинатальные и материнские результаты зависимы также на классификации гипертензивных нарушений беременности. Усилия, чтобы выборочно идентифицировать, правильно диагностировать, и оптимально лечить каждую гипертензивную мать должны помочь достигать лучшего возможного результата с наименее материнским риском.

TI: Hypertension in pregnancy [clinical conference]

TI: Артериальная гипертензия в беременности [клиническая конференция]

AU: Lindheimer-MD

AD: Department of Obstetrics and Gynecology, University of Chicago, Ill.

SO: Hypertension. 1993 Jul; 22(1): 127-37

CP: UNITED-STATES

AB: High blood pressure, which complicates approximately 10% of all pregnancies, remains a major cause of morbidity and mortality for both mother and fetus. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis by clinical criteria alone, may be among the reasons why there are many conflicts about the management of hypertension during pregnancy. This clinical conference summarizes current concepts regarding the hypertensive disorders of gestation, focusing on the most dangerous cause, preeclampsia-eclampsia. It further highlights a recent report of the Working Group on High Blood Pressure in Pregnancy convened by the National High Blood Pressure Education Program at the National Heart, Lung, and Blood Institute (the Consensus Report). Among the Working Group's most interesting recommendations in controversial areas were a return to the classification schema suggested by the American College of Obstetricians and Gynecologists in 1972, use of the fifth Korotkoff sound to determine diastolic blood pressure levels, and institution of treatment with antihypertensive drugs for sudden elevations of blood pressure near term to diastolic levels greater than or equal to 105 mm Hg or for levels of 100 mm Hg or higher in pregnant women with chronic hypertension. The Consensus Report further recommended parenteral hydralazine and methyldopa as the drugs of choice for the acute hypertensive crisis and management of chronic hypertension, respectively, based on the long histories of safe use of these agents in gravidas. Parenteral magnesium sulfate remained the preferred therapeutic approach for avoiding or treating the convulsive complication, eclampsia, but the Working Group underscored the need for controlled trials of magnesium's efficacy. Finally, they noted that diuretics should be avoided in preeclampsia, but that these drugs can be continued during gestation if taken before conception, and may be prescribed to pregnant women with chronic hypertension who appear overly salt sensitive.