hypertension disorders of pregnancy 10% 2 Organization WHO 24 h + 30 mg /dl 20 ACOG

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1 Chin J Obstet Emerg Electronic Edition February 2014Vol. 3No. 1 The American College of Obstetricians and Gynecologists ACOG gzdrchen@ gzhmu. edu. cn ACOG hypertension disorders of pregnancy 10% 2 World Health preeclampsia Organization WHO 5 ~ h mg /dl % ACOG 9. 4% ACOG National High Blood Pressure Education Program Working Group NHBPEP ACOG ACOG 300 mg /24 h DOI /cma. j. issn fetal growth restrictionfgr

2 mmhg a 2 4 h 160 mmhg 110 mmhg 24 h 300 mg. / μmol /L. + < /L μmol /L 2 2 a 1 mmhg = kpa mmhg a 110 mmhg 2 4 h < /L μmol /L 2 a 1 mmhg = kpa eclampsia 48 h 25% 8 48 ~ 72 h mmhg chronic hypertension mmhg chronic hypertension with superimposed preeclampsia < /L μmol /L gestational hypertension 8 Ⅰ Ⅱ 9

3 PlGF /seng ACOG logistic A 7 pregnancy-associated plasma protein A PAPP-A PlGF 93. 1% ~ ~ kg /m % 60% 2013 ACOG biomarkers soluble vascular endothelial growth factor receptor-1 soluble fms-like tyrosine kinase-1 sflt-1 placenta growth factor PlGF vascular < 34 endothelial growth factorvegf soluble endoglin seng sflt ~ 5 12 sflt-1 sflt-1 seng PlGF 100% 98% 2013 ACOG 1 60 ~ 80 mg 2 C E 3 4 PlGF 9 ~ 11 sflt PlGF < 600 mg /d 1. 5 ~ 2. 0 g Kusanovic 19 D

4 ACOG 8 C 37 E 9 < mmhg < 110 mmhg HELLP 2013 ACOG 2013 ACOG ACOG ~ RR = % CI ~ ACOG FGR < 160 mmhg < 110 mmhg ACOG < 34 7 < 37 1

5 mmhg 110 mmhg < /L FGR < 5 6 < 5 cm h h

6 45 7 ~ 10 d 24 ~ 48 h mmhg 100 mmhg 2 4 ~ 6 h 160 mmhg 110 mmhg 1 h 2013 ACOG J Placenta < FGR 48 h pressure in pregnancy J. Am J Obstet Gynecol S1-S22. ACOG 6American College of Obstetricians and Gynecologists. Practice Bulletin No. J. Obstet Gynecol Pt ~ 6 g 1 ~ 2 g /h 7 24 h J M HELLP HELLP hemolysis H elevated liver enzymesel low platelets LP ACOG 1 HELLP 2 34 HELLP J 3 < HELLP 1Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Hypertension in pregnancy executive summaryj. Obstet Gynecol Shalom GShoham-Vardi ISergienko Ret al. Is preeclampsia a significant risk factor for long-term hospitalizations and morbidity. J Matern Fetal Neonatal Med Telang MABhutkar SPHirwani RR. Analysis of patents on preeclampsia detection and diagnosis a perspective J.. J. 5National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Report of the national high blood pressure education program working group on high blood ACOG 125 Chronic hypertension in pregnancy Rosser MLKatz NT. Preeclampsia an obstetrician's perspective J. Adv Chronic Kidney Dis J Leandro De OliveiraJosé C Pera olimaria T Pera oliet al. sflt-1 / PlGF ratio as a prognostic marker of adverse outcomes in women with early-onset preeclampsia J. Pregnancy Hypertension 12SibaiBDekkerGKupfermincM. Pre-eclampsiaJ. Lancet Janzarik WGEhlers EEhmann Ret al. Dynamic Cerebral Autoregulation in Pregnancy and the Risk of PreeclampsiaJ. Hypertension Steegers EAvon Dadelszen PDuvekot JJet al. Pre-eclampsia. Lancet Meads CACnossen JSMeher Set al. Methods of prediction

7 46 and prevention of pre-eclampsia systematic reviews of accuracy and effectiveness literature with economic modelingj. Health Technol Assess World Health Organization. WHO recommendations for prevention J Akercan FCirpan TTerek MCet al. The immunohistochemical evaluation of VEGF in placenta biopsies of pregnancies complicated by preeclampsiaj. Arch Gynecol Obstet Akolekar RZaragoza EPoon LCet al. Maternal serum placental growth factor at to weeks of gestation in the prediction of pre-eclampsia J. Ultrasound Obstet Gynecol Kusanovic JPRomero RChaiworapongsa Tet al. A prospective cohort study of the value of maternal plasma concentrations of angiogenic and anti-angiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia J. J Matern Fetal Neonatal Med Poon LCKametas NAMaiz Net al. First-trimester prediction of hypertensive disorders in pregnancyj. Hypertension Bujold ERoberge SLacasse Yet al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy a meta-analysisj. Obstet Gynecol Pt and treatment of pre-eclampsia and eclampsiadb /OL. Geneva http / /whqlibdoc. who. int /publications / 2011 / _eng. pdf 23Hypp nen E. Vitamin D for the prevention of preeclampsia A Hypothesis J. Nutr Rev Bezerra Maia E Holanda Moura SMarques Lopes LMurthi Pet al. Prevention of preeclampsiaj. J Pregnancy Koopmans CMBijlenga DGroen Het al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation HYPITAT a multicentreopen-label randomised controlled trialj. Lancet Freitas LGAlpoim PNKomatsuzaki Fet al. Preeclampsia are platelet count and indices useful for its prognostic J. Hematology J /CD

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