On antihypertensive therapy before delivery.docVIP

 PAGE \* MERGEFORMAT 8 On antihypertensive therapy before delivery [Keywords:] antihypertensive treatment before delivery Hypertension is a common complication of pregnancy, is the second leading cause of maternal death and increased premature delivery, intrauterine growth retardation, placental abruption and perinatal mortality rate. In developed countries about 10% to 15% of pregnant women with hypertension. gestational hypertension include the following three types: primary or secondary hypertension, pregnancy-induced hypertension and preeclampsia, the latter two reasons are specific to pregnant women. different causes of the high pregnancy the pathogenesis of blood pressure, hemodynamic characteristics, complications and risks to mother and fetus are also different. Diuretics during pregnancy is very controversial. Although diuretics do not seem to affect the prognosis of the fetus, but the limited capacity of the normal expansion during pregnancy, and reduce the volume of amniotic fluid and electrolyte imbalance can trigger. Diuretic if blood pressure control before pregnancy, more important, or is associated with renal dysfunction, heart disease or fluid retention cases, diuretics continue to be applied is feasible, and often need combined with other drugs. diuretics hemodynamic features of cardiac stroke volume is decreased and systemic vascular contraction, so pregnant women if there is pre-eclampsia, you should not use diuretics. RAAS system changes during pregnancy and preeclampsia during AT1 receptor activation, in theory, support the application of ACEI and ARB pregnant women with hypertension drugs. Now these two drugs are widely used in protecting the kidney of young women of childbearing age, especially the presence of diabetes the case of kidney disease or proteinuria. However, due to ACEI and ARB drugs with fetal toxicity (including kidney malformations, neonatal skull hypoplasia and renal failure), often in preparation fo