Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
REPORT OF THE CANADIAN-HYPERTENSION-SOCIETY-CONSENSUS-CONFERENCE .3. PHARMACOLOGICAL TREATMENT OF HYPERTENSIVE DISORDERS IN PREGNANCY
Autore:
REY E; LELORIER J; BURGESS E; LANGE IR; LEDUC L;
Indirizzi:
HOP ST JUSTINE,DEPT OBSTET & GYNECOL,3175 COTE ST CATHERINE MONTREAL PQ H3T 1C5 CANADA UNIV MONTREAL,DEPT MED MONTREAL PQ H3C 3J7 CANADA UNIV MONTREAL,DEPT OBSTET & GYNECOL MONTREAL PQ H3C 3J7 CANADA UNIV CALGARY,DEPT MED CALGARY AB T2N 1N4 CANADA UNIV CALGARY,DEPT OBSTET & GYNECOL CALGARY AB T2N 1N4 CANADA
Titolo Testata:
CMAJ. Canadian Medical Association journal
fascicolo: 9, volume: 157, anno: 1997,
pagine: 1245 - 1254
SICI:
0820-3946(1997)157:9<1245:ROTC.P>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONVERTING ENZYME-INHIBITORS; RANDOMIZED CONTROLLED TRIAL; FETAL HEART-RATE; MAGNESIUM-SULFATE; SEVERE PREECLAMPSIA; ANTIHYPERTENSIVE TREATMENT; NEUROMUSCULAR BLOCKADE; COMPLICATING PREGNANCY; INTRAVENOUS LABETALOL; SODIUM-NITROPRUSSIDE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
97
Recensione:
Indirizzi per estratti:
Citazione:
E. Rey et al., "REPORT OF THE CANADIAN-HYPERTENSION-SOCIETY-CONSENSUS-CONFERENCE .3. PHARMACOLOGICAL TREATMENT OF HYPERTENSIVE DISORDERS IN PREGNANCY", CMAJ. Canadian Medical Association journal, 157(9), 1997, pp. 1245-1254

Abstract

Objective: To provide Canadian physicians with evidence-based guidelines for the pharmacologic treatment of hypertensive disorders in pregnancy. Options: No medication, or treatment with antihypertensive ol anticonvulsant drugs. Outcomes: Prevention of maternal complications, and prevention of perinatal complications and death. Evidence: Pertinentarticles published from 1962 to September 1996 retrieved from the Pregnancy and Childbirth Module of the Cochrane Database of Systematic Reviews and from MEDLINE; additional articles retrieved through a manualsearch of bibliographies; and expert opinion. Recommendations were graded according to levels of evidence. Values: Maternal and fetal well-being were equally valued, with the belief that treatment side effectsshould be minimized. Benefits, harms and costs: Reduction in the rateof adverse perinatal outcomes, including death. Potential side effects of antihypertensive drugs include placental hypoperfusion,intrauterine growth retardation and long-term effects on the infant. Recommendations: A systolic blood pressure greater than 169 mm Hg or a diastolic pressure greater than 109 mm Hg in a pregnant woman should be considered an emergency and pharmacologic treatment with hydralazine, labetalol or nifedipine started. Otherwise, the thresholds at which to start antihypertensive treatment are a systolic pressure of 140 mm Hg or a diastolic pressure of 90 mm Hg in women with gestational hypertension without proteinuria or pre-existing hypertension before 28 weeks' gestation, those with gestational hypertension and proteinuria or symptoms at any time during the pregnancy, those with pre-existing hypertension and underlying conditions or target-organ damage, and those with pre-existing hypertension and superimposed gestational hypertension. The thresholds in other circumstances are a systolic pressure of 150 mm Hg or a diastolic pressure of 95 mm Hg. For nonsevere hypertension, methyldopa is the first-line drug; labetalol, pindolol, oxprenolol and nifedipine are second-line drugs. Fetal distress attributed to placental hypoperfusion is rare, and long-term effects on the infant are unknown. Magnesium sulfate is recommended for the prevention and treatment of seizures. Validation: The guidelines are more precise but compatible with those from the US and Australia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 18:03:53