妊娠高血压综合征的治疗及用药安全性的研究进展

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Abstract

Hypertensive disorders during pregnancy (HDP) represent a major cause of maternal, fetal and neonatal mortality and identifies women at risk for cardiovascular and other chronic diseases later in life. Treatment of HDP concerns both the mother and the fetus and depends on blood pressure (BP) level, gestational age, and presence of associated maternal and fetal risk factors. This article reviews the effect of antihypertensive drugs on mother and fetus when administered during pregnancy and/or post-partum. Treatment of mild hypertension and no end-organ damage during pregnancy remains controversial and there is no agreement about when to initiate antihypertensive therapy, optimal BP targets or recommended drugs. In severe hypertension the goal is to reduce BP to ＜160/105 mmHg over minutes to hours and then to achieve a sustained BP of 140-150/90-100 mmHg, and most guidelines recommend antihypertensive therapy with labetalol, methyldopa, or nifedipine. Nifedipine, labetalol and some angiotensin-converting enzyme inhibitors (captopril and enalapril) can be used safely during breastfeeding. This review could provide clinical references for treating HDP patients safety and effectively by describing antihypertensive drugs in details.

Key words： Hypertensive disorders during pregnancy Antihypertensive drugs Drug safety Research progress

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