妊娠中の高血圧における平均動脈圧の低下と胎児の成長制限:メタ解析
P von Dadelszen1, M P Ornstein, S B Bull
1Department of Obstetrics and Gynaecology, University of Toronto, Canada.
Lancet (London, England)
|February 16, 2000
まとめ
妊娠中の高血圧に対する経口抗高血圧薬は胎児の成長に悪影響を及ぼし,妊娠年齢の赤ちゃんがより小さくなる可能性があります. 母親と胎児のリスクと利益のバランスを取るためにさらなる研究が必要です.
科学分野:
- 産婦人科と産婦人科を担当しています.
- 産周医学は,産周医学である.
- 薬理学 薬理学とは
背景:
- 軽度から中等度の妊娠高血圧は,多くの妊娠に影響します.
- 口服抗高血圧薬は,この状態を管理するために一般的に使用されます.
- これらの薬が胎児胎盤の成長に与える影響については,さらなる調査が必要である.
研究 の 目的:
- 胎盤の成長と妊娠中の経口抗高血圧薬の使用との関係を調査する.
- 母親の血圧の変化と胎児の成長指標の関連性を評価する.
主な方法:
- ランダム化比較試験の公表データに関するメタレグレッション分析が行われました.
- 統計的なアウトライヤーから得られたデータは,プライマリ分析から除外された.
- 平均動脈圧 (MAP) の変化を胎盤の成長指標と比較した.
主要な成果:
- 抗高血圧療法によるMAPのより大きな減少は,妊娠年齢より小さい (SGA) 幼児のより高い割合と相関していました.
- また,出生時の平均体重の低下は,MAPの減少と関連していた.
- MAPの変化と胎盤の平均体重との間に有意な関係は見られなかった.
結論:
- 治療による母親の血圧の低下は胎児の成長に悪影響を及ぼす可能性があります.
- 妊娠中の軽度から中等度の高血圧を経口抗高血圧薬で治療する母親の利益は小さいようです.
- これらの治療の母体と胎児のリスクと利益を明らかにするために,さらなる研究が不可欠です.
関連する概念動画
Hormonal Regulation
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
Blood Pressure
Blood pressure (BP) is the pressure or force of blood exerted on the artery's walls as it circulates through the body. It is essential for maintaining blood flow throughout the body.
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
Factors affecting Blood pressure
Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Physiological Factors:
Special considerations while measuring blood pressure
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Blood Pressure
The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.


