切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2021, Vol. 10 ›› Issue (03) : 133 -137. doi: 10.3877/cma.j.issn.2095-3259.2021.03.002

专家论坛

子痫前期发生和发展过程中的预防
王伽略1, 杨孜1,()   
  1. 1. 100191 北京大学第三医院妇产科
  • 收稿日期:2021-01-23 出版日期:2021-08-18
  • 通信作者: 杨孜
  • 基金资助:
    北京市科技重大专项首都临床特色应用与成果推广(Z171100001017231)

Prevention of preeclampsia in its occurrence and development

Jialue Wang1, Zi Yang1()   

  • Received:2021-01-23 Published:2021-08-18
  • Corresponding author: Zi Yang
引用本文:

王伽略, 杨孜. 子痫前期发生和发展过程中的预防[J]. 中华产科急救电子杂志, 2021, 10(03): 133-137.

Jialue Wang, Zi Yang. Prevention of preeclampsia in its occurrence and development[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2021, 10(03): 133-137.

子痫前期的预防策略包括预防发生及预防发展,尤其防止发展成为重症。预防子痫前期的发生包括初级预防和对母体基础疾病的筛查与诊治,更强调对育龄妇女在孕前进行相关知识的教育;还有妊娠期间的管理,包括预警和早发现、早诊断,更重要的是早干预和早处理。在妊娠的任何时段,预防子痫前期发生是一个层面,预防发展到重度子痫前期是一个层面,避免母儿死亡又是一个层面,本文层层解析。

Prevention strategies of preeclampsia include the prevention of its occurrence and development, especially to prevent it from developing into severe cases. The prevention of preeclampsia includes primary prevention and screening and diagnosis of preexisting internal disease, emphasizing on health education of preeclampsia related knowledge for women of childbearing age. In addition to the primary prevention, the prevention of preeclampsia development also needs high quality management during pregnancy, including early warning, early detection, early diagnosis, and more importantly, early intervention and early treatment. Prevention of preeclampsia in any period of pregnancy is one administrative level, prevention of severe preeclampsia is another level, to avoid maternal and fetal death is one more level. This article analyzes with you layer by layer.

[1]
Shennan AH, Green M, Chappell LC. Maternal deaths in the UK: pre-eclampsia deaths are avoidable [J]. The Lancet, 2017, 389(10069): 582-584.
[2]
FIGO Working Group on Good Clinical Practice in Maternal-Fetal Medicine. Good clinical practice advice: first trimester screening and prevention of pre-eclampsia in singleton pregnancy [J]. Int J Gynaecol Obstet, 2019, 144(3): 325-329.
[3]
杨孜.子痫前期多因素发病及多机制发病通路之综合征再认识 [J].中华医学杂志,2015, 95(1): 7-9.
[4]
中华医学会妇产科学分会妊娠期高血压疾病学组. 妊娠高血压期疾病诊治指南(2020)[J].中华妇产科杂志,2020, 55(4): 227-238.
[5]
杨孜,张为远.《妊娠期高血压疾病诊治指南(2020)》解读 [J]. 中华妇产科杂志,2020,55(6): 425-432.
[6]
杨孜. 子痫前期综合征预防有待突破模式化更需多元化—从小剂量阿司匹林的应用谈起 [J]. 中华围产医学杂志,2017,20(10): 697-699.
[7]
杨孜,王伽略. 子痫前期-子痫∥曹泽毅.中华妇产科学(临床版).北京:人民卫生出版社,2010:154-170.
[8]
ACOG Practice Bulletin No.202: Gestational Hypertension and Preeclampsia [J]. Obstet Gynecol,2020,135(6): e237-e260.
[9]
Webster K, Fishburn S, Maresh M, et al. Diagnosis and management of hypertension in pregnancy: summary of updated NICE guidance [J]. BMJ, 2019, 366: 5119.
[10]
Butalia S, Audibert F, Côté AM, et al. Hypertension Canada′s 2018 guidelines for the management of hypertension in pregnancy [J]. Can J Cardiol, 2018, 34(5): 526-531.
[11]
Duley L, Meher S, Hunter KE, et al. Antiplatelet agents for preventing pre-eclampsia and its complications [J]. Cochrane Database Syst Rev, 2019(10): 1-286.
[12]
Rolnik DL, Wright D, Poon LC, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia [J]. N Engl J Med, 2017, 377(7): 613-622.
[13]
Roberts JM, Myatt L, Spong CY, et al. Vitamins C and E to prevent complications of pregnancy-associated hypertension [J]. N Engl J Med, 2010, 362(14): 1282-1291.
[14]
McCance DR, Holmes VA, Maresh JA, et al. Vitamins C and E for prevention of pre-eclampsia in women with type 1 diabetes (DAPIT): a randomised placebo-controlled trial [J]. Lancet,2010, 376(9737): 259-266.
[15]
Braillon A, Bewley S.Re: prenatal vitamin C and E supplementation in smokers is associated with reduced placental abruption and preterm birth: a secondary analysis [J]. BJOG,2015,122(6): 884-885.
[16]
Vadillo-Ortega F, Perichart-Perera O, Espino S, et al. Effect of supplementation during pregnancy with L arginine and antioxidant vitamins in medical food on preeclampsia in high risk population: randomized controlled trial [J].BMJ, 2011,342: d2901.
[17]
Palacios C, Trak-Fellermeier MA, Martinez RX, et al. Regimens of vitamin D supplementation for women during pregnancy [J]. Cochrane Database Syst Rev, 2019, 10(10): 1-191.
[18]
Bao LX, Shi WT, Han YX. Metformin versus insulin for gestational diabetes: a systematic review and meta-analysis [J]. J Matern Fetal Neonatal Med, 2019, 34(26): 2741-2753.
[19]
Dodd JM, Louise J, Deussen AR, et al. Effect of metformin in addition to dietary and lifestyle advice for pregnant women who are overweight or obese: the GRoW randomized, double-blind, placebo-controlled trial [J]. Lancet Diabetes Endocrinol, 2019, 7(1): 15-24.
[20]
Ahmed A, Williams DJ, Cheed V, et al. Pravastatin for early-onset pre-eclampsia: a randomised, blinded, placebo-controlled trial [J]. BJOG, 2020,127(4): 478-848.
[21]
王伽略,杨孜,宋颖,等. 非规律产前检查孕妇子痫前期发病的影响因素[J].中华围产医学杂志,2015,31(6): 425-429.
[22]
杨孜. 防范子痫前期综合征需多元化和有选择性[J].中国实用妇科与产科杂志,2018,34(5): 465-470.
[23]
杨孜. 子痫前期从疾病提升认识到综合征如何再前行——谈亚分类亚分型理论与实践及基础与临床研究之路[J]. 中国实用妇科与产科杂志,2019,35(1): 41-47.
[24]
史峻梅,杨孜,陈蕾,等.重度子痫前期患者临床发病前预警信息分析[J]. 中华妇产科杂志,2009, 44(5): 337-340.
[25]
陈扬,杨孜,宋颖,等. 重度子痫前期病情发展与衍变396例分析 [J].中国实用妇科与产科杂志,2015,31(10): 937-941.
[26]
杨孜. 妊娠期高血压疾病在真实临床世界实践之辨析[J]. 中国实用妇科与产科杂志,2019,35(4): 408-416.
[27]
宋颖,杨孜,沈洁,等. 规律产前检查子痫前期患者早期临床发病特点分析 [J]. 中国实用妇科与产科杂志,2014,30(6): 457-461.
[28]
von Dadelszen P, Payne B, Li J, et al. Prediction of adverse maternal outcomes in pre-eclampsia: development and validation of the fullPIERS model[J]. Lancet, 2011,377(9761): 219-227.
[29]
Ukah UV, Payne B, Hutcheon JA, et al. Assessment of the fullPIERS Risk Prediction Model in Women With Early-Onset Preeclampsia [J]. Hypertension,2018,71(4): 659-665.
[30]
黄萍,杨孜,张坤,等.重度子痫前期191例严重并发症的监测[J].中国实用妇科与产科杂志,2006,22(11): 828-831.
[1] 杨皓媛, 龚杰, 邹青伟, 阮航. 哮喘孕妇的母婴不良妊娠结局研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 522-529.
[2] 陈甜甜, 王晓东, 余海燕. 双胎妊娠合并Gitelman综合征孕妇的妊娠结局及文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 559-568.
[3] 居晓庆, 金蕴洁, 王晓燕. 剖宫产术后瘢痕子宫患者再次妊娠阴道分娩发生子宫破裂的影响因素分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 575-581.
[4] 顾娟, 孙擎擎, 胡方方, 曹义娟, 祁玉娟. 子宫内膜容受性检测改善胚胎反复种植失败患者妊娠结局的临床应用[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 582-587.
[5] 周梦玲, 薛志伟, 周淑. 妊娠合并子宫肌瘤的孕期变化及其与不良妊娠结局的关系[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 611-615.
[6] 陈莉, 雷雪芹, 段炼, 曾悦, 何国琳. 影响2次剖宫产术后阴道试产产妇试产成功因素及妊娠结局分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 287-294.
[7] 陈樱, 陈艳莉. 高龄孕妇心率变异性原因及围产结局分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 295-301.
[8] 冯丹艳, 曹晓辉, 史玉霞. 血清脂联素与胎盘亮氨酸氨肽酶对妊娠期糖尿病患者妊娠结局的影响[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 302-308.
[9] 刘艳艳, 谭曦, 彭雪. 妊娠合并膀胱低度恶性潜能乳头状尿路上皮肿瘤并文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 212-218.
[10] 韦先梅, 韩毓, 蒋英彩. 敲减circSERPINE2通过靶向调控miR-34a-5p表达抑制滋养层细胞增殖、迁移和侵袭[J]. 中华细胞与干细胞杂志(电子版), 2023, 13(04): 193-201.
[11] 任国华, 杜晓晓, 洪善玲, 邵帅. 妊娠期高血压并发急性肾损伤患者血清白细胞介素-22、硫化氢及护骨素水平的变化与意义[J]. 中华肾病研究电子杂志, 2023, 12(03): 150-155.
[12] 张郁妍, 胡滨, 张伟红, 徐楣, 朱慧, 羊馨玥, 刘海玲. 妊娠中期心血管超声参数与肝功能的相关性及对不良妊娠结局的预测价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 499-504.
[13] 王欣, 刘琳, 闻哲嘉, 刘春玲, 张弘, 吕芳. 妊娠前应激暴露对小鼠后续妊娠的影响[J]. 中华临床医师杂志(电子版), 2023, 17(04): 431-437.
[14] 吴晓翔, 杨波, 李景漩, 张凤玲, 郭桂辉, 郑少培. 脐动脉超声检查联合NLR、sFlt-1/PLGF对妊娠高血压综合征患者不良妊娠结局的预测价值[J]. 中华临床医师杂志(电子版), 2023, 17(03): 266-271.
[15] 张丽姿, 陈敦金. 胎盘植入性疾病的不良结局及远期影响[J]. 中华产科急救电子杂志, 2023, 12(03): 155-158.
阅读次数
全文


摘要