Pre-eclampsia
Pre-eclampsia
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子痫前期（又称先兆子痫，是妊娠期特有的一种疾病，以妊娠20周后出现高血压、蛋白尿为主要特征，严重时可出现抽搐、昏迷等症状，威胁母婴生命健康）
DOI：
10.1038/s41572-023-00417-6
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发表时间：
2023-02-16
影响因子：
81.5
通讯作者：
Menkhorst, Ellen
中科院分区：
文献类型：
--
作者：
Dimitriadis, Evdokia;Rolnik, Daniel L.;Menkhorst, Ellen
先兆子痫是人类特有的一种危及生命的妊娠疾病，也是孕产妇和新生儿发病和死亡的主要原因。先兆子痫幸存下来的女性预期寿命会缩短，中风、心血管疾病和糖尿病的风险增加，而先兆子痫怀孕的婴儿早产、围产期死亡、神经发育障碍以及晚年心血管和代谢疾病的风险增加。先兆子痫是一种复杂的多系统疾病，诊断为突发性高血压（妊娠超过 20 周）和至少一种其他相关并发症，包括蛋白尿、母体器官功能障碍或子宫胎盘功能障碍。先兆子痫仅在胎盘存在或最近存在时才被发现，分为早产（分娩=妊娠 37 周）和产后先兆子痫。先兆子痫的母体综合征是由功能失调的胎盘引起的，胎盘将因子释放到母体血液中，导致全身炎症和广泛的母体内皮功能障碍。现有的治疗方法针对孕产妇高血压和癫痫发作，但先兆子痫的唯一“治愈方法”是功能障碍的胎盘和婴儿的分娩，而且通常是过早分娩。尽管经过数十年的研究，先兆子痫的病因学，特别是足月和产后先兆子痫的病因学仍然不明确。在预测和预防早产先兆子痫方面已取得重大进展，通过联合筛查在妊娠早期预测早产先兆子痫，并从妊娠 16 周前开始每日服用小剂量阿司匹林进行预防。相比之下，足月和产后先兆子痫的预测是有限的，并且没有预防性治疗。未来的研究必须调查先兆子痫的发病机制，特别是足月和产后先兆子痫的发病机制，并在充分有力的临床试验中评估新的预后测试和治疗方法。先兆子痫是一种危及生命的妊娠疾病，也是孕产妇和新生儿发病和死亡的主要原因。 Dimitriadis 及其同事撰写的这本入门书总结了先兆子痫的流行病学、机制、诊断和治疗，并讨论了患者的生活质量和该疾病的开放研究问题。
Pre-eclampsia is a life-threatening disease of pregnancy unique to humans and a leading cause of maternal and neonatal morbidity and mortality. Women who survive pre-eclampsia have reduced life expectancy, with increased risks of stroke, cardiovascular disease and diabetes, while babies from a pre-eclamptic pregnancy have increased risks of preterm birth, perinatal death and neurodevelopmental disability and cardiovascular and metabolic disease later in life. Pre-eclampsia is a complex multisystem disease, diagnosed by sudden-onset hypertension (>20 weeks of gestation) and at least one other associated complication, including proteinuria, maternal organ dysfunction or uteroplacental dysfunction. Pre-eclampsia is found only when a placenta is or was recently present and is classified as preterm (delivery = 37 weeks of gestation) and postpartum pre-eclampsia. The maternal syndrome of pre-eclampsia is driven by a dysfunctional placenta, which releases factors into maternal blood causing systemic inflammation and widespread maternal endothelial dysfunction. Available treatments target maternal hypertension and seizures, but the only 'cure' for pre-eclampsia is delivery of the dysfunctional placenta and baby, often prematurely. Despite decades of research, the aetiology of pre-eclampsia, particularly of term and postpartum pre-eclampsia, remains poorly defined. Significant advances have been made in the prediction and prevention of preterm pre-eclampsia, which is predicted in early pregnancy through combined screening and is prevented with daily low-dose aspirin, starting before 16 weeks of gestation. By contrast, the prediction of term and postpartum pre-eclampsia is limited and there are no preventive treatments. Future research must investigate the pathogenesis of pre-eclampsia, in particular of term and postpartum pre-eclampsia, and evaluate new prognostic tests and treatments in adequately powered clinical trials.Pre-eclampsia is a life-threatening disease of pregnancy and a leading cause of maternal and neonatal morbidity and mortality. This Primer by Dimitriadis and colleagues summarizes the epidemiology, mechanisms, diagnosis and treatment of pre-eclampsia, and discusses patient quality of life and open research questions for this condition.