40 2014 2 3 1 Chin J Obstet Emerg Electronic Edition February 2014Vol. 3No. 1 The American College of Obstetricians and Gynecologists ACOG Email gzdrchen@ gzhmu. edu. cn 17 2013 ACOG 2013 11 1 6-8 hypertension disorders of pregnancy 10% 2 World Health preeclampsia Organization WHO 5 ~ 6 1 24 h 3 + 30 mg /dl 20 9 25% 2013 1991 ACOG 9. 4% 4 20 2013 ACOG 2000 2 National High Blood Pressure Education Program Working Group NHBPEP 5 3 4 2013 ACOG 4 1 2013-2 ACOG 300 mg /24 h DOI 10. 3877 /cma. j. issn. 2095-3259. 2014. 01. 010 510150 fetal growth restrictionfgr
41 1 1 20 140 90 mmhg a 2 4 h 160 mmhg 110 mmhg 24 h 300 mg. / 26. 52 μmol /L. + < 100 10 9 /L 97. 24 μmol /L 2 2 a 1 mmhg = 0. 133 kpa 2 1 160 mmhg a 110 mmhg 2 4 h < 100 10 9 /L 2 97. 24 μmol /L 2 a 1 mmhg = 0. 133 kpa eclampsia 48 h 25% 8 48 ~ 72 h 20 140 90 mmhg chronic hypertension 20 140 90 mmhg chronic hypertension with superimposed preeclampsia 20 1 10-11 2 3 < 100 10 9 /L 4 5 6 1 2 3 97. 24 μmol /L 4 5 2 7 6 7 gestational hypertension 8 Ⅰ Ⅱ 9
42 10 11 40 PlGF /seng 12-13 2013 ACOG logistic A 7 pregnancy-associated plasma protein A PAPP-A PlGF 93. 1% 10 16. 5 0. 06 20 2. -13-13 17 5. 0 ~ 20 0. 1 ~ 0. 8 14 27 34 kg /m 2 3 90% 60% 2013 ACOG 14-15 biomarkers 1. 20 21-22 -1 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 11 16 sflt-1 9 4 ~ 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-1 5 17-18 PlGF < 600 mg /d 1. 5 ~ 2. 0 g Kusanovic 19 D 1 622 22-23
43 2013 ACOG 8 C 37 E 9 < 22 24 160 mmhg < 110 mmhg HELLP 2013 ACOG 2013 ACOG 1 2013 ACOG 37 1 5 2009 25 756 2 1 36 ~ 41 1 2 37 1 RR = 0. 71 95% CI 0. 59 ~ 0. 86 3 2013 ACOG FGR < 160 mmhg < 110 mmhg 4 5 2 6 2013 ACOG 1 34 2 < 34 7 < 37 1
44 2 3 34 1 2 3 4 5 4 6 7 160 mmhg 110 mmhg 9 5 6 10 11 7 33 + 6 12 1 2 3 < 100 10 9 /L4 13 2 5FGR < 5 6 < 5 cm7 8 14 48 h 8 33 + 6 15 72 h
45 7 ~ 10 d 24 ~ 48 h 16 17 18 150 mmhg 100 mmhg 2 4 ~ 6 h 160 mmhg 110 mmhg 1 h 2013 ACOG J Placenta201334 12-8. < 34 4 199126 167-71. FGR 48 h pressure in pregnancy J. Am J Obstet Gynecol 2000 2013 S1-S22. ACOG 6American College of Obstetricians and Gynecologists. Practice Bulletin No. J. Obstet Gynecol2012119 2 Pt 1396-407. 4 ~ 6 g 1 ~ 2 g /h 7 24 h J. 1027 8. M. 8. 2013 64-71. HELLP HELLP hemolysis H elevated liver enzymesel low platelets LP 20133 3191-195. 8 26 2013 ACOG 1 HELLP 2 34 HELLP J 3 < 33 + 6 HELLP 1Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Hypertension in pregnancy executive summaryj. Obstet Gynecol2013122 51122-1131. 2Shalom GShoham-Vardi ISergienko Ret al. Is preeclampsia a significant risk factor for long-term hospitalizations and morbidity. J Matern Fetal Neonatal Med201326 113-15. 3Telang 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 183 1 ACOG 125 Chronic hypertension in pregnancy. 201220 111023-9Rosser MLKatz NT. Preeclampsia an obstetrician's perspective J. Adv Chronic Kidney Dis201320 3287-296. 10. - J. 201348 4268-271. 11Leandro 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 2005365 9461785-799. 13Janzarik WGEhlers EEhmann Ret al. Dynamic Cerebral Autoregulation in Pregnancy and the Risk of PreeclampsiaJ. Hypertension201463 1161-166. 14Steegers EAvon Dadelszen PDuvekot JJet al. Pre-eclampsia. Lancet2010376 9741631-644. 15Meads CACnossen JSMeher Set al. Methods of prediction
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