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首页> 外文期刊>Best practice & research:Clinical obstetrics & gynaecology >Severe pre-eclampsia and hypertensive crises
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Severe pre-eclampsia and hypertensive crises

机译：严重先兆子痫和高血压危机

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摘要

Hypertensive disorders of pregnancy are one of the leading causes of peripartum morbidity and mortality globally. Hypertensive disease in pregnancy is associated with a spectrum of severity, ranging from mild pregnancy-induced hypertension to eclampsia. Although most cases of pre-eclampsia may be managed successfully, severe pre-eclampsia is a life-threatening multisystem disease associated with eclampsia, HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome, acute kidney injury, pulmonary oedema, placental abruption and intrauterine foetal death. Management of severe pre-eclampsia includes identification of high-risk patients, optimisation of antenatal care, early intervention and the identification and early management of complications. In the first instance, oral anti-hypertensive agents, including labetalol, nifedipine and methyldopa, should be tried. If oral anti-hypertensive agents have failed to adequately control blood pressure, intravenous anti-hypertensives should be considered. Commonly used intravenous anti-hypertensives include labetalol, hydralazine and glyceryl trinitrate. In addition to anti-hypertensive agents, close attention should be given to regular clinical examination, assessment of fluid balance, neurologic status and monitoring of other vital signs. Magnesium sulphate should be considered early to prevent seizures. Delivery of the baby is the definitive management of severe pre-eclampsia.
机译：妊娠高血压疾病是全球围产期发病率和死亡率的主要原因之一。妊娠高血压疾病与轻度妊娠相关，从轻度妊娠诱发的高血压到子痫。尽管大多数先兆子痫病例可以成功治疗，但严重先兆子痫是与子痫，HELLP（溶血，肝酶升高，低血小板）综合征，急性肾损伤，肺水肿，胎盘早剥和宫内胎儿死亡。严重先兆子痫的治疗包括高危患者的识别，产前护理的优化，早期干预以及并发症的识别和早期处理。首先，应尝试口服降压药，包括拉贝洛尔，硝苯地平和甲基多巴。如果口服降压药未能充分控制血压，则应考虑静脉使用降压药。常用的静脉降压药包括拉贝洛尔，肼苯哒嗪和三硝酸甘油酯。除抗高血压药外，应密切注意常规临床检查，体液平衡评估，神经系统状况和其他生命体征监测。硫酸镁应尽早考虑以预防癫痫发作。婴儿的分娩是严重先兆子痫的最终治疗方法。

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