摘要
本文报告3例慢性高血压合并阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)的双胎孕妇应用持续气道正压通气(continuous positive airway pressure,CPAP)后的母儿结局。3例双胎孕妇均合并慢性高血压;均因夜间有打鼾、呼吸暂停症状,行多导睡眠图监测,诊断为OSAHS。病例1孕28周行CPAP治疗后1个月,血压缓慢升高,伴尿蛋白增加,孕34周并发溶血、肝酶升高、血小板减少综合征剖宫产;病例2孕11周行CPAP治疗,孕期血压平稳,孕37周行剖宫产;病例3孕13周行CPAP治疗4个月后血压升高,尿蛋白阳性,经药物治疗,血压降低,尿蛋白转阴,孕32周因并发胎膜早破行剖宫产,CPAP治疗至分娩,母婴结局良好。由这3例认为,CPAP可能延缓慢性高血压合并OSAHS双胎孕妇孕期血压上升的时间,有助于减少不良母婴结局。
This paper reports the maternal and fetal outcomes of three twin pregnancies with chronic hypertension and obstructive sleep apnea-hypopnea syndrome(OSAHS)who were treated with continuous positive airway pressure(CPAP).All three women with twin pregnancies were diagnosed with chronic hypertension.Furthermore,symptoms such as snoring and apnea assisted the diagnosis of OSAHS through polysomnography monitoring.Case 1 was treated with CPAP at 28 gestational weeks.The blood pressure increased gradually after the first month of CPAP treatment,with an elevated urine protein concentration.At 34 gestational weeks,the pregnant woman underwent a cesarean section due to the development of hemolysis,elevated liver enzymes,and low platelet syndrome.Case 2 was treated with CPAP at 11 gestational weeks,with stable blood pressure throughout the pregnancy,and was delivered through cesarean section at 37 weeks of pregnancy.Case 3 started CPAP at 13 gestational weeks for four months,and increased blood pressure and urine protein were observed.Medication brought the blood pressure down,and urine protein became negative.At 32 gestational weeks,a cesarean section was performed because of premature rupture of the membrane.Her CPAP treatment continued till delivery with good maternal and infant outcomes.The treatment outcomes of the three cases suggest that CPAP may prolong the time of blood pressure rise among twin pregnancies where chronic hypertension and OSAHS coexist,which potentially reduces the occurrence of adverse maternal and infant outcomes.
作者
吕晓
王晶玉
魏俊
杨京晶
韩芳
刘国莉
Lyu Xiao;Wang Jingyu;Wei Jun;Yang Jingjing;Han Fang;Liu Guoli(Department of Obstetrics and Gynecology,Peking University People's Hospital,Beijing 100044,China;Department of Obstetrics and Gynecology,Maternal and Children Care Hospital of Linfen City,Linfen 041000,China;Department of Respiratory and Sleep Medicine,Peking University People's Hospital,Beijing 100044,China)
出处
《中华围产医学杂志》
CAS
CSCD
北大核心
2024年第3期241-244,共4页
Chinese Journal of Perinatal Medicine
基金
北京市自然科学基金(京津冀基础科研合作专项22JCZXJC00160)。
关键词
高血压
睡眠呼吸暂停
阻塞性
连续气道正压通气
妊娠
双胎
Hypertension
Sleep apnea,obstructive
Continuous positive airway pressure
Pregnancy,twin