Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, Am...Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, American College of Obstetricians and Gynecologists （ACOG） updated the diagnostic criteria for PE and redtlced the diagnostic value of proteinuria for patients with PE. Qualitative analysis of the diagnostic value of 24-h proteinuria for patients with PE in China was conducted to evaluate the diagnostic criteria value in the latest ACOG guideline. Methods： Complete clinical data of 65 patients with hypertensive disorder in pregnancy （HDP） were collected. All patients were delivered to and hospitalized in Renji Hospital. Adverse outcome was defined in case of the emergence of any serious complication for a mother or the fetus. A retrospective study was conducted according to ACOG guideline, to analyze the relationship between each diagnostic criteria of ACOG guideline and maternal and perinatal outcomes. Spearman correlation test was used to detect the association between each diagnostic criterion, its corresponding value, and the adverse pregnancy outcome. Logistic regression was performed to verily the result of Spearman correlation test. Results： Of 65 HDP patients, the percentage of adverse pregnancy outcome was 63.1%. Adverse pregnancy outcomes constitute diversification. There were 55 cases with 24-h proteinuria value ≥0.3 g, of which the adverse outcome rate was 74.5%. While adverse pregnancy outcomes did not appear in the rest 10 HDP patients with proteinuria 〈0.3 /24 h. The statistic difference was significant （P = 0.000）. However, no significant difference was tbund in other criteria groups （impaired liver function： P = 0.417; renal insufficiency： P = 0.194; thrombocytopenia： P - 0.079： and cerebral or visual symptoms： P = 0.296）. The correlation coefficient between 24-h proteinuria ≥0.3 g and adverse pregnancy outcomes was 0.557 （P 〈 0.005）. hnpaired liver function （P = 0.180）, renal insufficiency （P =0.077） and cerebral or visual symptoms （P = 0.118） were not related to adverse outcomes, The 24-h proteinuria value （HDP： r= 0.685; PE： r= 0.521）, liver enzyme value （HDP： r= 0.519; PE： r= 0.501）, and creatinine value （HDP： r= 0.511; PE： r= 0.398） were associated with adverse pregnancy outcomes both in PE and HDP, and the corresponding logistic regression equation can be produced. Conclusions： The 24-h proteinuria value is still an important diagnostic criterion for PE, and deletion of 24-h proteinuria value from diagnostic criteria for severe PE was not recommended. The diagnostic criteria in ACOG guideline need to be verified in Chinese women.展开更多
妊娠期高血压疾病是妊娠期常见的疾病,以高血压、水肿、蛋白尿、抽搐、昏迷、心肾功能衰竭,甚至发生母儿死亡为临床特点。在过去十年内,对子痫前期的认识已取得实质性的进展。但是,包括美国在内,对妊娠期高血压疾病的分类、诊断和处理...妊娠期高血压疾病是妊娠期常见的疾病,以高血压、水肿、蛋白尿、抽搐、昏迷、心肾功能衰竭,甚至发生母儿死亡为临床特点。在过去十年内,对子痫前期的认识已取得实质性的进展。但是,包括美国在内,对妊娠期高血压疾病的分类、诊断和处理方案仍不规范,为了推出一个基于循证医学成果的最佳诊疗指南,2011年,美国妇产科医师学会（ACOG）成立了关于妊娠期高血压疾病工作组（American College of Obstetricians and Gynecologists’Task Force on Hypertension in Pregnancy），展开更多
妊娠期高血压疾病是全世界范围内导致孕产妇和围产儿死亡的重要原因之一,全球发病率在2%~8%。因其影响范围广泛、不良妊娠结局发生率高以及高昂的医疗花费,妊娠期高血压疾病一直是全球产科医生关注的重点。2019年美国妇产科医师学会(Ame...妊娠期高血压疾病是全世界范围内导致孕产妇和围产儿死亡的重要原因之一,全球发病率在2%~8%。因其影响范围广泛、不良妊娠结局发生率高以及高昂的医疗花费,妊娠期高血压疾病一直是全球产科医生关注的重点。2019年美国妇产科医师学会(American College of Obstetricians and Gynecologists,ACOG)发布了'妊娠期高血压和子痫前期指南2019版”[1],本指南主要针对妊娠期高血压和子痫前期,在2013版指南[2]的基础上加入了最近几年该领域的研究进展,包括疾病的背景信息和处理建议两部分内容。现针对该指南第一部分内容解读如下。展开更多
文摘Background： Preeclarnpsia （PE） is a serious idiopathic disease posing a threat to both mothers and fetuses＇ lives during pregnancy, whose main diagnostic criteria include hypertension with proteinuria. However, American College of Obstetricians and Gynecologists （ACOG） updated the diagnostic criteria for PE and redtlced the diagnostic value of proteinuria for patients with PE. Qualitative analysis of the diagnostic value of 24-h proteinuria for patients with PE in China was conducted to evaluate the diagnostic criteria value in the latest ACOG guideline. Methods： Complete clinical data of 65 patients with hypertensive disorder in pregnancy （HDP） were collected. All patients were delivered to and hospitalized in Renji Hospital. Adverse outcome was defined in case of the emergence of any serious complication for a mother or the fetus. A retrospective study was conducted according to ACOG guideline, to analyze the relationship between each diagnostic criteria of ACOG guideline and maternal and perinatal outcomes. Spearman correlation test was used to detect the association between each diagnostic criterion, its corresponding value, and the adverse pregnancy outcome. Logistic regression was performed to verily the result of Spearman correlation test. Results： Of 65 HDP patients, the percentage of adverse pregnancy outcome was 63.1%. Adverse pregnancy outcomes constitute diversification. There were 55 cases with 24-h proteinuria value ≥0.3 g, of which the adverse outcome rate was 74.5%. While adverse pregnancy outcomes did not appear in the rest 10 HDP patients with proteinuria 〈0.3 /24 h. The statistic difference was significant （P = 0.000）. However, no significant difference was tbund in other criteria groups （impaired liver function： P = 0.417; renal insufficiency： P = 0.194; thrombocytopenia： P - 0.079： and cerebral or visual symptoms： P = 0.296）. The correlation coefficient between 24-h proteinuria ≥0.3 g and adverse pregnancy outcomes was 0.557 （P 〈 0.005）. hnpaired liver function （P = 0.180）, renal insufficiency （P =0.077） and cerebral or visual symptoms （P = 0.118） were not related to adverse outcomes, The 24-h proteinuria value （HDP： r= 0.685; PE： r= 0.521）, liver enzyme value （HDP： r= 0.519; PE： r= 0.501）, and creatinine value （HDP： r= 0.511; PE： r= 0.398） were associated with adverse pregnancy outcomes both in PE and HDP, and the corresponding logistic regression equation can be produced. Conclusions： The 24-h proteinuria value is still an important diagnostic criterion for PE, and deletion of 24-h proteinuria value from diagnostic criteria for severe PE was not recommended. The diagnostic criteria in ACOG guideline need to be verified in Chinese women.
文摘妊娠期高血压疾病是妊娠期常见的疾病,以高血压、水肿、蛋白尿、抽搐、昏迷、心肾功能衰竭,甚至发生母儿死亡为临床特点。在过去十年内,对子痫前期的认识已取得实质性的进展。但是,包括美国在内,对妊娠期高血压疾病的分类、诊断和处理方案仍不规范,为了推出一个基于循证医学成果的最佳诊疗指南,2011年,美国妇产科医师学会（ACOG）成立了关于妊娠期高血压疾病工作组（American College of Obstetricians and Gynecologists’Task Force on Hypertension in Pregnancy），
文摘妊娠期高血压疾病是全世界范围内导致孕产妇和围产儿死亡的重要原因之一,全球发病率在2%~8%。因其影响范围广泛、不良妊娠结局发生率高以及高昂的医疗花费,妊娠期高血压疾病一直是全球产科医生关注的重点。2019年美国妇产科医师学会(American College of Obstetricians and Gynecologists,ACOG)发布了'妊娠期高血压和子痫前期指南2019版”[1],本指南主要针对妊娠期高血压和子痫前期,在2013版指南[2]的基础上加入了最近几年该领域的研究进展,包括疾病的背景信息和处理建议两部分内容。现针对该指南第一部分内容解读如下。
