妊娠期低血压的临床特征及围产儿结局

Clinical features and perinatal outcomes of gestational hypotension

目的:了解妊娠期低血压的发生率及临床特征,分析妊娠及围产儿结局。方法:回顾性选取2018年2月在广州市妇女儿童医疗中心建档的早期妊娠单胎孕妇956例,按照血压情况分为三组:1.低血压组(收缩压<90 mmHg且舒张压<60 mmHg);2.正常血压组(收缩压90~139 mmHg且舒张压60~89 mmHg);3.高血压组(收缩压≥140 mmHg或舒张压≥90 mmHg),追踪不同妊娠时期低血压的发生率及围产儿结局。结果:低血压在孕期总发生率为16.7%,中期妊娠低血压发生率最高(12.34%)。异常血压组临床症状发生率高于正常血压组(P<0.001)。低血压组早产发生率及足月低体重儿发生率高于正常血压组(P<0.05)。结论:妊娠期低血压在临床上有一定发生率,且有不良围产结局,故临床上需加强对妊娠低血压孕妇的管理及监测。

Objective:To investigate the incidence and clinical features of gestational hypotension and its pregnancy and perinatal outcomes.Methods:A retrospective study was conducted on 956 women registered to Guangzhou Women and Children’s Medical Center in February 2018 during their first trimester of singleton pregnancy.These women were assigned to three groups according to blood pressure,namely,the hypotensive group(systolic blood pressure < 90 mmHg and diastolic blood pressure <60 mmHg),the normotensive group(systolic blood pressure 90-139 mmHg and diastolic blood pressure 60-89 mmHg)and the hypertensive group(systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg). The incidence of hypotension at any trimesters and the subsequent perinatal outcomes were followed up.Results:The overall incidence of gestational hypotension was 16.7%,with the rate was the highest during the second trimester(12.34%).The pregnant women with hypo-or hypertension were more likely to present with clinical symptoms compared with those in the normotensive group(P<0.001).The rates of preterm delivery or full-term low birth weight infants were higher in the hypotensive group than in the normotensive group( P< 0. 05).Conclusion:Gestational hypotension is not uncommon in medical settings and may lead to adverse perinatal outcomes,rendering the need for intensive care and monitoring of the pregnant women with gestational hypotension in clinical practice.