HYPERTENSION IN PREGNANCY

妊娠期高血压

• 批准号: 3357027
• 负责人: Thomas J. Benedetti
• 金额: $ 10.45万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1988
• 资助国家: 美国
• 起止时间: 1988-07-01 至 1992-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3357027
• 关键词: blood flow measurement; blood pressure; body weight; carbon monoxide; cardiac output; disease /disorder proneness /risk; eclampsia; gestational age; hemodynamics; human pregnant subject; human subject; longitudinal human study; pathologic process; pregnancy circulation disorder; pregnancy disorder chemotherapy; pregnancy toxemia /hypertension; respiratory gas level; statistics /biometry; ultrasound blood flow measurement; vascular resistance

Preeclampsia is a syndrome characterized by the development of hypertension and proteinuria in the third trimester of pregnancy. It is responsible for 6% of premature births and is the second leading cause of maternal mortality. Gant et al, by measuring angiotension sensitivity and dehydroisoandrosterone clearance, demonstrated that pathophysiological changes occur weeks prior to the manifestation of clinical hypertension. Increased systemic vascular resistance is thought to be associated with these early changes and eventually leads to hypertension. However, hemodynamic measurements late in the disease reveal a diversity of findings with a significant number of patients having elevated cardiac output and normal systemic vascular resistance. The heterogeneity of findings suggest that preeclampsia may be a dynamic process requiring a longitudinal design for study. Our preliminary data support a hypothesis that the primary hemodynamic alteration early in the disease is elevated CO. The goals of the projects are to define the longitudinal hemodynamic changes in women destined to become preeclamptic. We will test the hypothesis that early preeclampsia is manifest by increased CO which is followed by hypertension. One hundred and seventy nulliparous women will be studied over three years. Cardiac output, blood pressure and weight will be measured at regular intervals starting before 22 weeks. At the conclusion of each pregnancy, subjects will be classified as normotensive, hypertensive without protenuria or preeclamptic. Data from the preeclamptic and hypertensive patients will be compared with those who remain normotensive. An understanding of the longitudinal hemodynamic changes in preeclampsia will serve as the foundation of further research into a common disease process which is associated with significant morbidity. It may aid in the detection of incipient preeclampsia, suggest preventive therapy, and help direct the treatment of women with overt disease.

子痫前期是一种综合征，其特征是 怀孕三个月的高血压和蛋白尿。 它负责6％的早产，是第二个 孕产妇死亡率的主要原因。 Gant等人，通过测量 血管敏感性和脱氢异源性清除率， 证明病理生理变化发生在几周前 临床高血压的表现。 全身性增加 人们认为血管抗性与这些早期有关 变化并最终导致高血压。 然而， 在疾病后期，血流动力学测量表明多样性 大量患者升高的发现 心脏输出和正常的全身血管抗性。 这 发现的异质性表明先兆子痫可能是 需要纵向设计的动态过程。 我们的 初步数据支持主要的假设 疾病早期的血液动力学改变升高。 项目的目标是定义纵向 妇女的血液动力学变化注定要成为 先兆子痫。 我们将检验以下假设：早期先兆子痫 由增加的CO表现出来，其次是高血压。 将研究一百七十个无效的妇女 三年。 心输出，血压和体重将是 从22周之前开始定期测量。 在 每次怀孕的结论，受试者将被归类为 具有正常性，高血压，没有蛋白尿或先兆子痫。 先兆子痫和高血压患者的数据将是 与那些保持平常的人相比。 了解纵向血流动力学变化 子痫前期将成为进一步研究的基础 与大量有关的常见疾病过程 发病率。 它可能有助于检测初期的先兆子痫， 建议预防治疗，并有助于指导治疗 患有明显疾病的妇女。