2019ACOG实践简报_妊娠期慢性高血压(No.203).pdfVIP

ACOG PRACTICE BULLETIN Clinical Management Guidelines for Obstetrician–Gynecologists NUMBER 203 Committee on Practice Bulletins—Obstetrics. This Practice Bulletin was developed by the American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics in collaboration with Alex Vidaeff, MD, MPH; Jimmy Espinoza, MD, MSc; Hyagriv Simhan, MD; and Christian M. Pettker, MD. D o w n l o a d e d f r o m Chronic Hypertension in Pregnancy h t t p : / / j o u r n Chronic hypertension is present in 0.9–1.5% of pregnant women (1) and may result in significant maternal, fetal, and a l s . l w w neonatal morbidity and mortality. The rate of maternal chronic hypertension increased by 67% from 2000 to 2009, . c o m / g with the largest increase (87%) among African American women. This increase is largely secondary to the obesity r e e n j o u epidemic and increasing maternal age (1, 2). The trend is expected to continue. r n a l b y The purpose of this document is to clarify the criteria used to define and diagnose chronic hypertension before or B h D M f during pregnancy, to review the effects of chronic hypertension on pregnancy and vice versa, and to appraise the 5 e P H K available evidence for management options. The purpose of these revised best practice recommendations is to provide b H 4 T T I a rational approach to chronic hypertension in pregnancy based on new research data and relevant pathophysiologic m q e n V and pharmacologic considerations. A J P 5 B D j q W (AHA) have changed the criteria for diagnosing hyperten- 5 1 l Background a j x