cg107 migrated
TRANSCRIPT
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!K K: !K K:
C>> G>
G>: 25 AGG 2010
..G=/G/107
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CC
"G ......................................................................................................................................................................... 4
- ........................................................................................................................................................ 6
$K >............................................................................................................................... 7
1 G ............................................................................................................................................................................ 9
DS........................................................................................................................................................................................... 9
1.1 G = KH K...................................................................................... 10
1.2 & K I K ............................................................................................ 12
1.3 A G KH K ................................................................... 15
1.4 & K I > K..................................................................................... 15
1.5 & K I ->........................................................................................................... 19
1.6 F> ........................................................................................................................................................................ 24
1.7 "G ....................................................................................................................................................................... 26
1.8 &> H K H -> > ............ 27
1.9 B............................................................................................................................................................................. 30
1.10 AH >>I-G GK .................................................................................... 31
2 G ........................................................................................................................ 34
3 "> .............................................................................................................................................................. 35
4 ...................................................................................................................................... 36
4.1 G = KH K ..................................................................................... 36
4.2 A G KH K ................................................................... 36
4.3 !>> > I I > K............................. 37
4.4 I I ->............................................................................................................... 37
4.5 AKH .................................................................................................................. 38
5 H G>................................................................................................................................ 39
5.1 FG>> G>............................................................................................................................................................................... 39
5.2 '" G> .................................................................................................................................................... 39
6 > "CE G................................................................................................................................................. 40
Hypertension in pregnancy (CG107)
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7 G> ................................................................................................................................................. 41
AJ A: G> DH> G "CE < .................................................. 42
AJ B: G> HI >................................................................................................................. 44
AJ C: >........................................................................................................................................... 45
AJ D: DG ..................................................................................................................................... 46
C G>............................................................................................................................................... 48
AG G> .......................................................................................................................................................... 49
Hypertension in pregnancy (CG107)
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G> 35.
"G"G
!KH G K G I I -J K K
K, I I H> I- K >
K.
!KH G K K = I K. A>G
> $ ($) H >>, K K
> G > $. !KH GK K > G> G> > K. A $ GK -
H > K I G KH . A GK
$ 1 20 (5%) I I H -> > I
H . & >K, >- G I I
K G K H >, G> K
> HG> =.
!KH > K = K. " $ > >K
, 1 20 (5%) >> IG > >K G I I
->. G -> H>> G>;
1 250 (0.4%) I S K I>> H 34 I= G
-> 8P10% >> G> KH . !> I
I H -> H .
>>-->- (>K G > I >>
) , I 20P25% 14P19% I I
-> > > I .
> G I I H -> >
KH G K1
. !IH, G
I K (>G
G KH ) K I I K.
>> G>
KH G K >, G > . "
Hypertension in pregnancy (CG107)
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>G I I K I I H
H I K > K K.
>> G>
KH G K >, G > . "
>G I I K I I H
H I K > K K.
G> G I>> G G' GK G (C)
I HG> . DG I G> G>
> I G K > = IQ
> J D.
G> G I K H $ =
G G>, H G G. &K G
H > G S>>K I, T G
J>G G. > G = I =.
" G>, G = I = (*) K H $ =
G G G> (AGG 2010). "
G> G.
1K> C>> K> (2006) H
->/>; > "G !> C>> EJ>> (2008) A>
. "CE >> G> 62. : > "G !> C>> EJ>>.
Hypertension in pregnancy (CG107)
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- -
G> H I I KH
K.
G> = G I' . I
KH K G> H GK =
G , I > >. " I
H K = , > > G> >>I D
!>' H &> CK A.
G I > > I >. " G>
G K H- I > I' . , I H G , G> G>G>>K . " G> >
> > I > G K>, K > >,
> I = E>.
Hypertension in pregnancy (CG107)
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$$K >K >
G = G = KHKH K K
AH I = -> = 75 * >K 12 I= G>
K. = I K >>I:
KH G HG K
=K
GG G K >GG K >
K
K 1 K 2
K. 1.1.2.11.1.2.1
& K I & K I KK
>> I I = -H LK (ACE) ""
>= (AB):
= > > G =
G K
G KH I > >
> K, K > K. 1.2.1.11.2.1.1
" I I G> K = > G
>I 150/100 !. 1.2.3.11.2.3.1
A G A G KHKH K K
G - H GK :
G K . 1.3.1.11.3.1.1
& K I > & K I > KK
I I > K = H
>, , G > G, G >
> 1. 1.4.1.31.4.1.3
Hypertension in pregnancy (CG107)
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& K I ->& K I ->
I I -> = H >,
, G > G, G >
> 2. 1.5.1.21.5.1.2
CG> G> G I' > (>,
>> >>) > > >H 34 I= I
I ->. 1.5.2.21.5.2.2
>> I I H -> > HI > HI
(6P8 I= ). 1.5.3.101.5.3.10
AH >>I-G AH >>I-G GK GK
>> I I -> = H>:
> K GG K G 1 8 (13%)
G 1 2 (53%)
-> GG K G G 1 6 (16%)
-> GG K G 1 4 (25%) -> I > K H ->, !E K >
> 34 I=, G 1 2 (55%) >
28 I=. 1.10.4.21.10.4.2
Hypertension in pregnancy (CG107)
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11 GG
>>I G H>> H. G>> G> H >
H G H> G.
D%/
F G G>, >>I S >K:
C C KK K = H 20 I=
I >K = KH I K
H. " K K >K.
E>E> HG>H I ->.
!E K!E K >K, >H >H LK >I >> G.
> > KK I K 20 I= IG S
G.
->-> I K 20 I= I S G.
HH -> -> -> I H K / I K, /
> / >> .
S GS G S 1.3.1.3
" , G> DH> G (D) S >, H
K > I > G >>I:
&> &> KK > > G 90P99 !, K> > G
140P149 !.
&& KK > > G 100P109 !, K> > G
150P159 !.
HH KK > > G 110 ! , K> > G
160 ! .
G G > G K 'A>
' ("CE >> G> 62).
Hypertension in pregnancy (CG107)
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" G>, >H >K G G >G K
>H .
1.1 R%$# % + /& %%% $/$% %!#
1.1.11.1.1 K ->K ->
1.1.1.1 I G> I = H
> > K J K ->.
K >G:
H
> I H, G >G T K
H <G >I
H
G I>> , .
'A> ' ("CE >> G> 62).
1.1.21.1.2 A>> A>>
1.1.2.1 AH I = -> = 75 * >K
12 I= G> K. = I K
>>I:
KH G HG K
=K
GG G K >GG K >
K
K 1 K 2
K.
Hypertension in pregnancy (CG107)
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1.1.2.2 AH I I = ->
= 75 * >K 12 I= G> K. F
= :
S K
40 K >
K H> 10 K
K J (B&") 35 =/2
S H
>K K ->
G>> K.
1.1.31.1.3 G> G>
1.1.3.1 D G >>I H KH G K:
J
G
>I >G> I .
1.1.41.1.4 G> G>G> G>
1.1.4.1 D >>I G> >>K I H
KH G K:
G
>
J (H C E)
S > >> >
>.
Hypertension in pregnancy (CG107)
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1.1.51.1.5 DD
1.1.5.1 D > G K >>K H
> K ->.
1.1.61.1.6 K>K>
1.1.6.1 AH , J I= I = KH
G K G> >K I (
'A> ', "CE >> G> 62).
1.2 M!!%% /& %!# #/# %%/
I K G> H H > I
'!K: K G> K ' ("CE >> G>
34) (> K '!K: >> K K G>' "CE
>> G> 127), G> S>>K G>.
1.2.11.2.1 -K H-K H
1.2.1.1 >> I I = -H LK (ACE)
"" >= (AB):
= > > G =
G K
G KH I > >
> K, K > K.
1.2.1.2 KH I = ACE AB
K (>K I 2 I= K S
K) >H.
1.2.1.3 >> I I = >L:
K = > >K >
> G = G K
G KH I > >
> K, K > K.
Hypertension in pregnancy (CG107)
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1.2.1.4 >> I I = KH ACE ,
AB >L > H H>> I
= > > I G .
1.2.21.2.2 DD
1.2.2.1 EG I I K = K G
= >I, K G GG G >, G
G > G. ( '!K:
K G> K ' "CE >> G>
34 > K '!K: >> K K
G> M"CE >> G> 127N.)
1.2.31.2.3 KK
1.2.3.1 " I I G> K = >
G >I 150/100 !.
1.2.3.2 D I I G> K
>I > > G >I 80 !.
1.2.3.3 I I - K
K ( J>, =K ) I =
> G >I 140/90 !.
1.2.3.4 I I K K >
> KH .
1.2.3.5 I I K KH
-J , - S> K.
1.2.41.2.4 A> G>A> G>
1.2.4.1 " I I K, G> > >
G> HG> I K.
Hypertension in pregnancy (CG107)
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1.2.51.2.5
1.2.5.1 D I I K I > G
>I 160/110 !, I IG KH ,
37 I=.
1.2.5.2 F I I K I > G >I 160/
110 ! 37 I=, I IG KH ,
> > G> I
I .
1.2.5.3 I I K H K,
G ( G) >.
1.2.61.2.6 > > HH, ,
1.2.6.1 " I I K I H H , G >
G:
>K S 2 K
> I K 3 K 5
>>>K KH .
1.2.6.2 " I I K I H H , = >
G >I 140/90 !.
1.2.6.3 " I I K I H H :
G > KH .
HI >- KH 2 I=
.
1.2.6.4 " I = K>Q
K G
K, I 2 K KH
I I = > K.
Hypertension in pregnancy (CG107)
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1.2.6.5 I I K > HI >
HI (6P8 I= ) I -K .
1.3 A%% /& /%! %%% $/$% /& %!#
1.3.1.1 G - H GK
: G K .
1.3.1.2 " G - H G G
G> 1+ , G GK :
24-G G >> GK G.
1.3.1.3 D S G GK : 30 /> H> 24-G G >> G> I
300 .
1.3.1.4 24-G G >> G GK G, G>
H>G > >.
1.4 M!!%% /& %!# %!/! %%/
1.4.11.4.1 KK
1.4.1.1 " I I > K G>> G> G
K K > > I
KH .
1.4.1.2 " I I > K, = G >>I =
G >
>>I-G:
G>>K
40 K >
K H> 10 K
>K K ->
G>> K
Hypertension in pregnancy (CG107)
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B&" 35 =/2
>
HG K -> > K
-J HG>
-J =K .
1.4.1.3 I I > K =
H >, , G > G,
G > > 1.
> 1 & K I > > 1 & K I > KK
D D
KK
&> &> KK
(140/90 149/ (140/90 149/
9999 !)!)
&& KK
(150/100 159/ (150/100 159/
109109 !)!)
HH KK
(160/110(160/110 ! !
))
A A
>>
(G> >
G 159/
109 ! >I)
> >>>
Q
S->
=:
> >
G I
80P100 !
K> > G
> 150 !
> >>>Q
S->
=:
> >
G I
80P100 !
K> >
G >
150 !
&G&G
>>
GG
I=
A > I I= A > G
K
Hypertension in pregnancy (CG107)
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GG
A H G
G -
H GK
:
A H G
G -
H GK
:
D>K G G
-
H GK
:
B> B> >K G
>
=K G,
>>K, G>> >
G, ,
>G
D K G G
>
G GG
H
I=>K:
=K G,
>>K, G>>
> G,
,
>G
1.4.1.4 >K I I > K KH
>>> - S> I, G
I K. A>H >G K>Q
Q.
1.4.1.5 " I H G H > K,
H>K >> >, G > G
G I I=>K K G I=>K > .
1.4.1.6 " I I > K 32 I=, =
-> ( 1.1.1.1), G > G G I I=>K.
1.4.1.7 D > > K.
1.4.21.4.2
1.4.2.1 D 37 I= I I > K
I > G >I 160/110 !, I IG
KH .
1.4.2.2 F I I > K I > G >I
160/110 ! 37 I=, I IG KH ,
, > > G>
I I .
Hypertension in pregnancy (CG107)
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1.4.2.3 I I K H > K
G ( G) >.
1.4.31.4.3 > > HH, ,
1.4.3.1 " I I > K I H H , G >
G:
>K S 2 K
> I K 3 K 5
>>>K KH .
1.4.3.2 " I I > K I H H :
G G > KH
G KH > G >> >I 140/
90 !
G KH > G >> >I 130/80 !.
1.4.3.3 " I = K>Q
> K, I
2 K .
1.4.3.4 F I I > K I = KH
H H , KH >
G 149/99 !.
1.4.3.5 > I I > K I H H
GK >G >>
>>I:
I I>> H >>I-G , >G > HI
GK > G
> G
> K > G HI.
Hypertension in pregnancy (CG107)
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1.4.3.6 I I H > K
KH 2 I= GK , >
HI.
1.4.3.7 I I H > K > HI
> HI (6P8 I= ).
1.4.3.8 I I H > K I >>
KH > HI
(6P8 I= ) > K.
1.5 M!!%% /& %!# %-%#!!
1.5.11.5.1 KK
1.5.1.1 A I I -> G>. A G>
K > >
KH K.
1.5.1.2 I I -> = H
>, , G > G,
G > > 2.
> 2 & K I ->> 2 & K I ->
D D
KK
&> &> KK
(140/90 149/ (140/90 149/
9999 !)!)
&& KK
(150/100 159/ (150/100 159/
109109 !)!)
HH KK
(160/110(160/110 ! !
))
A A
>>
Hypertension in pregnancy (CG107)
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> >>>Q
S->
=:
> >G I
80P100 !
K> >
G >
150 !
> >>>Q
S->
=:
> >G I
80P100 !
K> >
G >
150 !
&G&G
>>GG
A > G K A > G K & G
K, >>G
GG
D
GS
G
D
GS
G
D
GS
G
B> B> & G
>>I I
I=: =K G,>>K, G>> >
G, ,
>G
& G
>>I
I=: =KG, >>K, G>>
> G,
, >G
& G
>>I
I=: =KG, >>K, G>>
> G,
, >G
1.5.1.3 >K I I -> KH
>>> - S> I, G
I K. A>H >G K>Q
Q.
1.5.21.5.2
1.5.2.1 & K I I -> HH>K ( ,
> -K >HK K) G> 34 I=.
1.5.2.2 CG> G> G I' >
(>, >> >>) > > >H
34 I= I I ->.
Hypertension in pregnancy (CG107)
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1.5.2.3 CG> G> I > > >
G .
1.5.2.4 I I -> 34 I=, G I
> G H
:
H K H> K
> > H> S G> > ( 1.5.22).
1.5.2.5 I I H -> I H K
34 I= I > G >> G
> ( ).
1.5.2.6 I I H -> I >
K 34+0
36+6
I= > > ,
= H>>K > H .
1.5.2.7 I 24P48 G I I H -> I
> K 37+0
I=.
1.5.31.5.3 > > HH, (>G , (>G
> > ))
B//$ B//$ % %%%
1.5.3.1 " I I -> I = KH
H H , G > G:
> G K I> I
> I K 3 K 5
> K G> > > G I > K 3P5.
1.5.3.2 " I I -> I = KH
H H , KH > G 150/
100 ! .
Hypertension in pregnancy (CG107)
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1.5.3.3 A= I I -> I H H G H
> G G.
1.5.3.4 " I I -> I = KH H
H , G > G:
> G K I> I
HK 1P2 K G 2 I= GK G> I
K.
1.5.3.5 F I I -> I H = KH
H H :
G > KH
G KH > G >> >I 140/
90 !
G KH > G >> >I 130/80 !.
1.5.3.6 " I = K>Q
->, I 2 K
.
1.5.3.7 I I -> I H H GK
>> >>I H :
K ->
> G, I IG , 149/99 ! >I
> G> > H.
1.5.3.8 > I I -> I H H
GK >G >> >>I:
I I>> H >>I-G , >G > HI
GK > G
> G
Hypertension in pregnancy (CG107)
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> K > G HI
>- K.
1.5.3.9 I I H -> >> KH
2 I= GK > HI.
1.5.3.10 >> I I H -> > HI >
HI (6P8 I= ).
1.5.3.11 I I H -> I >> KH
> HI (6P8 I= ) >
K.
H!%!//#! !$ "/#%#! // H!%!//#! !$ "/#%#! //
1.5.3.12 " I I H -> I > K,
-I > :
G >> G, G 48P72 G
-I
>> G, G G
G> > 48P72 G.
1.5.3.13 " > >> H G K I
> I I -> I H H ,
>> G, G G >>>K
> HI (6P8 I= ).
1.5.3.14 " > >> H >H K I I -> I H H ,
>> G, G G >>>K
.
1.5.3.15 " I I -> I H H , K G GK -
> HI (6P8 I= ).
Hypertension in pregnancy (CG107)
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1.5.3.16 " I I -> I H H H I
> >H> 2, G TG > I
> .
1.5.3.17 I I -> >> H G (1+ )
> HI (6P8 I= ) G HI 3
=K G >
> =K .
1.6 F%! //
1.6.11.6.1 C C KK
1.6.1.1 " I I K, K G G>G > I
TG H>G G>> K > H>K
I 28 30 I= I 32 34 I=. " G> >,
34 I=, G> I >>>K .
1.6.1.2 " I I K, >K K G K >
HK >.
1.6.21.6.2 &> &> > > KK
1.6.2.1 " I I > > K, K G G>G
> I TG H>G G>> K >
H>K S > 34 I=. " G> >,
34 I=, G> I >>>K .
1.6.2.2 " I I > > K, K G
G>G > I TG H>G G>>
K > H>K S 34 I=, G>
I >>>K .
1.6.2.3 " I I > > K, >K K G
K > HK >.
Hypertension in pregnancy (CG107)
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1.6.31.6.3 HH > > K ->K ->
1.6.3.1 CK G K H > K
->.
1.6.3.2 " HH H > K -
> >, K G >> >>I :
G>G > I TG H>G
G>> K > H>K.
1.6.3.3 " G> >> > > I I H >
K ->, G>K K
I=>K.
1.6.3.4 " I I H > K ->,
K K >>I G:
I > H
H> >
>
> .
1.6.3.5 " I I H > K ->,
G>K G>G > I TG H>G
G>> K > H>K HK 2 I=.
1.6.3.6 " G> K > I I H >
K -> >, >> G> .
1.6.3.7 F I I H > K ->, I
> >G >> >>I:
G GG >
> I G> H
Hypertension in pregnancy (CG107)
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I G I > G> =
> I G> .
1.6.41.6.4 = -> = ->
1.6.4.1 CK G G>G > I TG H>G
G>> K > H>K I 28 30 I= (
> 2 I= HG > > 28 I=)
4 I= > I I HG:
H ->
-> 34 I=
-> I K I I I > 10 >
G
>> G.
1.6.4.2 " I I = -> ( 1.1.2.2), >K K G
K > HK >.
1.7 I!! #!%
I KH G K G> H H >
I '"G : >HK I >G' ("CE >>
G> 55), G> S>>K G>.
1.7.11.7.1 B> GB> G
1.7.1.1 DG >G, G > G:
G>K I I > K
G>>K I I H K.
1.7.1.2 CG G > KH G >G.
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1.7.21.7.2 !>> > !>> >
1.7.2.1 D >> > G >G
I I > K G
> H > > .
1.7.31.7.3 C G GC G G> >> >
1.7.3.1 D > I I H H -> I HG TG
> >I- G> > > G>
>.
1.7.41.7.4 & >G& >G
1.7.4.1 D G>K > G >G:
I I > > K
> G >> I I I H
K.
1.7.4.2 H >G I I
H K I K >
.
1.8 M%$#! !!%% /& %%% %%/ / %%% %-%#!! !
##! #!% %
1.8.11.8.1 AAHG>HG>
1.8.1.1 " I > I H K H -
> HG>K > S, H HG G
G>*.
1.8.1.2 C H HG G G>* I I H -
> I > > I 24 G.
1.8.1.3 " G G>* , G >>I G
H ->:
Hypertension in pregnancy (CG107)
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H K G
> K G I >>I:
K H
> I H, G >G T K
H <G >I H
>>
>G (R3 )
>H
!E K
>> G >> >I 100 J 109
>
> >H LK (A A H 70 G/>).
1.8.1.4 C>>H E> >2
G G>*:
> 4 G> H HG>K H 5 G, >>I K
G 1 /G 24 G
G LG G> I G 2P4 H H 5 G.
1.8.1.5 D G L, K >K => >H G
G>* I I >.
1.8.21.8.2 AAKHKH
1.8.2.1 I I H K I > G
K >K I >>I:
>>>Q
(> HG)
K>L (HG)
Q (>).
Hypertension in pregnancy (CG107)
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1.8.2.2 " I I H K I > ,
:
G > G >>
K H I G
K .
1.8.2.3 C G G 500 > K>> TG
S HG K>L > .
1.8.2.4 " I I H K I > , = K>
> G >I 150 ! > > G I 80 100 !.
1.8.31.8.3 C > >G GC > >G G
1.8.3.1 " >=>K I 7 K I I ->:
H I * 12 GG>>K 24 G I
I 24 34 I=
H I * 12 GG>>K 24 G
I I 35 36 I=.
1.8.41.8.4 C !E KC !E K
1.8.4.1 D G J !E
K.
1.8.51.8.5 F>G > HF>G > H>G >G JJ
1.8.5.1 D G H>G J I I H -> G>
K>L > KH.
1.8.5.2 " I I H ->, > TG 80 >/G
G> TG > ( J>, ).
Hypertension in pregnancy (CG107)
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1.8.61.8.6 C HC HG G >GG G >G
1.8.6.1 C I I H K, H -
> > >> G I'
.
1.8.71.8.7 " " > > >> > >HH>>
1.8.7.1 I I H K H -> >
> G >>I 3
:
H> 3
H -> H>
H> 2
-I >H> 3 H -> I K >>I
>:
P >
P !E K
P
P K=>
P H >G
P G> G
P HG KH
P > > H K
P H >G
P > G>K
H> 1
P -> I > K
P HH > H
K
P -I
1.9 B%!&%%$
1.9.1.1 " I I >> KH > ,
H G K I
J >=.
Hypertension in pregnancy (CG107)
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1.9.1.2 >> I I >> KH >
>>I KH G H =I H
H >=:
>>>Q
Q
>>Q
>Q
>>Q
>>Q.
1.9.1.3 >> I I >> KH >
GS H K H >=
>>I KH G:
AB
>
ACE >>Q
>Q.
1.9.1.4 A >> I>> K, >>K GK , >
>K S 2 K .
1.10 A$#% !$ &//- #!% ! !&% / #/ #!%
1.10.11.10.1 - = - = HG> HG>
1.10.1.1 >> I I H > K ->,
K >, I
= H> > G > > >.
1.10.21.10.2 - = - =- = - =K K
1.10.2.1 >> I I K -> I H G
K > HI (6P8 I= ) >G
Hypertension in pregnancy (CG107)
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>H = - =K >G = >I
G >>I-G K.
1.10.31.10.3 > = ->> = ->
1.10.3.1 D G>K > I I H
->.
1.10.41.10.4 = G = G KHKH K K
1.10.4.1 >> I I > K = H>:
> K GG K G 1 6 (16%)
G 1 2 (47%)
-> GG K 1 50 (2%) G 1 14 (7%)
.
1.10.4.2 >> I I -> = H>:
> K GG K G 1 8 (13%)
G 1 2 (53%)
-> GG K G G 1 6 (16%)
-> GG K G 1 4 (25%) -
> I > K H ->, !E K >
> 34 I=, G 1 2 (55%) >
28 I=.
1.10.51.10.5 "-K H> G "-K H> G KHKH
KK
1.10.5.1 >> I I H -> > =
G I -K H> G 10 K.
1.10.61.10.6 BK BK J G J G KHKH K K
1.10.6.1 AH I I H -> H = B&" I
>K J K(18.5P24.9 =/
2, 'K', "CE >> G> 43).
Hypertension in pregnancy (CG107)
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2 E> > C>>H G (1995) HG> I I >?
EH C>>H E> >. L!#% 345:1455P63
3
> K G> DH> G "H C K, G> 2002.
Hypertension in pregnancy (CG107)
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22 G G
"CE G> H> I S I G> I>>
I>> H. G> H>>.
G> H I I I KH S G
K; I I H -J K > K
; I I = H> KH
G K. " > H G G> .
" H I I K I I H
KH G K.
!I G> I !I G> I HH>>
"CE > C>> C ' C>' !>
H> G>. C > G> H> G ( J A),
I HI H H> . A G>
HI > HI H> G> ( J B).
G I "CE >> G> H> "CE I.A =>, '!I "CE >> G> H>: HHI =>, G>
!' H>>.
Hypertension in pregnancy (CG107)
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33 ">">
"CE H> > > > G.
Hypertension in pregnancy (CG107)
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44
G> DH> G >>I ,
HI H, H "CE G GG. G>
DH> G' G>> > G>> G> (
5).
4.1 R%$# % + /& %%% $/$% %!#
!I >>>K H >G G> ( I >)
H -> I = ->?
K K
-> > K K >.
A>G > G G >G G> H KH
G K H G, H G> >G G K
G > >G H>G G K
. C>G G> , >=>K I>> >, >=>K
I G, >G S. EH
IG> >>K H >K . A I ->K,G G ->K , >K > K >G
= G>K -> =, = H GG = >
G G> > I >. FG >>
> G> > G J = G I = -
>, -J = G I >I = ->. >
G> > >G G K G> H>G >
G ( KH G K, >G H )
> G (> K, I H>).
4.2 A%% /& /%! %%% $/$% /& %!#
!I G> S G S I I K G K?
K K
& H G I- KH G K I
I G. !IH, G>K H S G
Hypertension in pregnancy (CG107)
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H>G G GK G>.
>, -G>K H G HG G G
(G - H, GK : , GK
>G: , 24-G G >>) I I I- KH
G K. G G> I G,
I >, G >>>K G.
G G IG> >> I- KH
G K. " H I S H
H G G> H>G >> >.
4.3 H!%!//#! !$ "/#%#! // /% %!/!
%%/
> >> > >
K G GH>> > K?
K K
-> G>K , G > I G
>> > I I > K > >>
GS>K K >>I . " I GG> > G I >>
G .
H G G> G J >K
>>K (=K G, >H G, G>, G G) I I
> K. G G> G >K H> K H>G
J >>>K G (H -> >
> >).
" I GS S, >> > G> G
=I> I =I> >> >
> G. > G> G> > >
H.
4.4 /& " /% %-%#!!
G> I I H -> I > K H ?
Hypertension in pregnancy (CG107)
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K K
'K' L I I H -> I > K
I 34 37 I= I > >.
I H -> I > K K H
I =, G > I = GI G> GI =
> > K. > H G G
> IG > S I K IG> H .
>> > G> G > >
I 34+0
36+6
I= I I H -> I >
K I J >> . G G>>G H -> >, > , > ,
> K >K, > . > > G J
> > I.
4.5 A%%% !% !$ "%!&%%$
!I >K G KH I G K I I
?
K K
KH G K,
I I>> >>K J KH . &
>H G > G K. F G
G >=, G K >> . A G>, I
K H > H .
G G> G >H G > >=,
= G G = (= >H> >) >
HG K>> H> I G G I I I
. G G> >>I I > G J>G
GG>H K G> > G H G > G
G> G.
Hypertension in pregnancy (CG107)
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55 H H G> G>
5.1 F $%%
G>> G>, '!K K' > H G
H> G>. " G> K > C>> C '
C>' !>, H>> G I.
5.2 'I&/!/ &/ % "#
A GK I / ('" G>') H>>.
G ! H>GK G J G I
G K K.
Hypertension in pregnancy (CG107)
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66 > "CE G> "CE G
, G K. "CE G> > G 27
(2010).
!I = K >>I >. "CE G> > G 26
(2010).
H HG> G> >H>. "CE G> > G 25
(2010).
C =K . "CE >> G> 73 (2008).
"G >G. "CE >> G> 70 (2008).
D K. "CE >> G> 63 (2008).
A> . "CE >> G> 62 (2008).
&> > G. "CE G> > G 11 (2008).
= H. "CE G> > G 10 (2008).
"G . "CE >> G> 55 (2007).
K. "CE >> G> 43 (2006).
> . "CE >> G> 37 (2006).
!K. "CE >> G> 34 (2006). > K "CE >> G> 127.
C . "CE >> G> 13 (2004). > K "CE >> G> 132.
Hypertension in pregnancy (CG107)
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77 G> G>
"CE >> G> G = G I
. I H = 3 K G>, > >
= HI; I G I >>
G> G. " I H G> , I K
G .
Hypertension in pregnancy (CG107)
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AJ A: G> DAJ A: G> DHH> G "CE < > G "CE <
G$%% $%%/% /
C BKC BK
> , I, >
> F>> F>
DGK D &IK, B> ! G
G> G>
CG> K>K, > HK !>
# !# !II
CG> >, HK C>> !> ! FG G
DDH # ( D 2009)H # ( D 2009)
C>> C-D, > C>> C ' C>' !>
< $ (G> &< $ (G> &K 2009)K 2009)
F>>I, > C>> C ' C>' !>
G &>G &>
CG> A, &K' !>,
F &>F &>
H, A ->
G &G &
H
&& &G> ( & &G> ( &K 2009)K 2009)
D G> DH>, > C>> C ' C>'
!>
K &G>K &G>
CG> &I, GK' ' ! FG G,
Hypertension in pregnancy (CG107)
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!> E, > C>> C '
C>' !>
A A
, K> B !S> ! FG G,
D= D= G>>G>>
CG> , B K> "SK
# # >=>=
K>K, HK
>=>=I (I (C)C)
CG> &> F> &, H> ' !>
DDH >>H >>
CG> K, HK C>> !> ! FG G
& > (G> D 2009)& > (G> D 2009)
C>> C-D, > C>> C ' C>' !>
NICE /*%# %!
> A>> A>
A D
C> $C> $/G /G
G> C &
= >/E> C>K= >/E> C>K>>
G> C
> > ==
>
# # KK/#GK &B /#GK &B
E
Hypertension in pregnancy (CG107)
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AJ B: G> AJ B: G> HI HI >>
G> HI > > H H>
G> = >K "CE G> H>
. " G>, > G => H G>K
. > >G >>I H:
K , K , >K, G> > GK.
&= &= DG ( DG (C)C)
!> E, C !> E, HK =
D D A A
> , CG, D
D G D G
D A, A K> "SK
D DD DH >>H >>
&> D, SL
C A=>C A=>KKK
Hypertension in pregnancy (CG107)
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AJ C: >AJ C: >
G>> G> >.
Hypertension in pregnancy (CG107)
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AJ D: DG AJ D: DG
A>> > K >K G I>K $ >
, G C (AGG 2010) H S I
> = G S K, I I K
I . " G >>
G G> G.
C> > K >K G $ >
, G C (AGG 2010) H
K >, G S
K. " G > G G>
G.
E>> > K >K G I>K $ >
, G C (AGG 2010) H
K G S
K S I I= >HK.
" G >> G G> G.
>> > K, >G G K >KG I>K $ , G C (AGG 2010) H G> >K G
G S K > S GI > =,
. " G >>> G
G> G.
&K> > K >K G I>K $
, G C (AGG 2010) H G I I , K
, I I G S
I > =. " G K> G
G> G.
&>> > K >K G I>K $ >
, G C (AGG 2010) H S I
> = G I I . "
G >> G G> G.
Hypertension in pregnancy (CG107)
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> K >K G I>K $
, G C (AGG 2010) H K I= 20,
G> G K I I K
. " > H G> G G . "
G G G> G.
Hypertension in pregnancy (CG107)
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C G>C G>
2012: 2012:
#GK 2012:#GK 2012: .
#GK 2011#GK 2011
I H G>> H G> I>> "CE H
G= G.
" & K I & K I KK '' ''
>>I ( 1.2.1.1 "CE H). " I :
% /% / !+% !/%-#/% %% (ACE) "/ / !/% II %#%/ "/#+%
(ARB):
! %% ! #%!%$ + /& #/%! !"/!% & %% $ !% !+% $ %!#
/ $# /% !%%% %!% % %!#!% /&%/! %/"% &/
!! % %%/, & % !% ! %!#.
" , '>L G' '>L'
1.2.1.3 1.2.1.4 "CE G> GG G>> G>. H
4 8 G= G. "> > H >
G.
I H "CE G> .
Hypertension in pregnancy (CG107)
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AG G>AG G>
"CE >> G> G > I S
! E> >.
G> I H> K > C>> C ' C>'
!>. C>> C I= I G > > (>G
G>, G), , > , I HI H
. I S> G> G>.
H> "CE >> G> G>
G>.
H G G> J> G>. > > KG G
G> G H > H>>.
G >KG >K
G HI "CE, I I H G>
H H>>. !> > J = G>>K G I
J >> <G. !IH, G H HG>>K > > = G
HG> , G> I / G , K
GK G K G K .
"> G >K >> / H.
C H >K >
G, >> J, > G H G>IG> H
G>K GK. G G>
IK IG> I > I G.
CCKK
O > "G !> C>> EJ>> 2010. A>> H. "CE K
> I> H GK, K G G>
--S G. G K > ,
> G, >>I IG I "CE.
Hypertension in pregnancy (CG107)
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C "CEC "CE
> "G !> C>> EJ>>
H> 1A, CK I, >>K >L, & &1 4B
III...G=
@..G=
0845 033 7780
A##%$!/
Hypertension in pregnancy (CG107)