妊娠中の血圧の測定と分類

J R Higgins¹, M de Swiet

¹Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, East Melbourne, Australia.

Lancet (London, England)

|February 24, 2001

まとめ

前出血栓症の定義は更新する必要がある. 高血圧とアルブミヌリアに焦点を当てた現在の基準は,頭痛や肝臓の問題などの重要な症状を逃し,診断と研究の正確さに影響を与えています.

科学分野:

産婦人科と産婦人科を担当しています.
妊産婦・胎児医学について
クリニカル診断士

背景:

妊娠前出血症は,通常,妊娠20週後の新発性高血圧とアルブミヌーリアによって定義されます.
従来型の診断基準は,子宮前出血症の全臨床スペクトルを捉えるのに限界があります.
腫はもはや決定的な特徴ではないが,重症で突然発症した腫は臨床的注意を要する.

研究の目的:

現在の妊娠前出血症の定義の限界を評価する.
高血圧とタンパク質尿以外の臨床症状を含むより広範な診断基準を提唱する.
妊娠前出血症について,別々の臨床的および研究的な定義を提案する.

主な方法:

妊娠前出血症の現在の診断基準のレビュー.
妊娠前出血症における臨床的変動性と関連する症状の分析.
既存の診断定義と提案された診断定義の比較.

主要な成果:

高血圧とタンパク質尿にのみ基づく既存の定義は,この症候群の臨床的多様性を説明できていません.
高血圧と重度な頭痛,血小板減少,胎児不全などの症状を有する女性は,タンパク質尿がない場合でも,予備分泌症を発症することがあります.
オーストラリアンとACOGのアプローチのような新しい定義は,より幅広い臨床的特徴を組み入れ始めています.

結論:

現在の子宮前出血栓症の定義は不十分であり,誤診または診断不足につながる可能性があります.
臨床的定義では,安全性と実用性を優先し,偽陽性の可能性がより多く認められるべきである.
研究の妥当性を向上させ,誤った陽性を排除するために,明確で厳格な研究定義が必要である.

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