子痫
子痫(eclampsia)是妊娠晚期、临产时、新产后发生的急性脑病,常出现抽搐和昏迷(癫痫发作),机制类似高血压脑病。子痫多数在先兆子痫基础上发作[1]。子痫前症是一种妊娠高血压疾病,且常并发水肿、蛋白尿或其他器官功能异常[2][3]。子痫可能会在分娩前、分娩中或分娩后发生。
子痫 | |
---|---|
类型 | 妊娠毒血症、疾病、life emergency[*] |
分类和外部资源 | |
医学专科 | 产科学 |
ICD-11 | JA25 |
ICD-10 | O15 |
ICD-9-CM | 642.6 |
DiseasesDB | 4068 |
MedlinePlus | 000899 |
eMedicine | 253960、1476919 med/1905 emerg/796 |
MeSH | D004461 |
子痫的发作是一种全身强直阵挛发作,约会持续一分钟。在癫痫后可能会处于癫痫发作后状态或是昏迷。并发症有吸入性肺炎、脑出血、肾功能衰竭或是心搏停止。子痫前症及子痫都可归类为妊娠高血压疾病[1]或妊娠高血压综合症(妊高征)。
字源及历史
编辑英语:eclampsia源自希腊语:ἐκλαμψία(eklampsía,意为闪电,隐喻其短暂爆发的特性)。第一个有关子痫症状的描述是在公元前五世纪的希波克拉底[4]。
预防及治疗方式
编辑建议的预防方式如下:高风险者服用阿司匹林,若钙质摄取量不足,使用钙质补充剂,针对早期的高血压给予药物治疗[5][6]。在怀孕期间运动也会有帮助[1]。若有子痫症状,肌肉注射或静脉注射硫酸镁可改善症状,一般来说是安全的[7][8],在发达国家及发展中国家都适用[7]。可能也需要设备来辅助呼吸,其他的治疗包括高血压药物肼屈嗪以及用阴道分娩或是剖宫产方式紧急将胎儿生下[1]。
流行病学,预后
编辑产妇中约有5%会得到子痫前症,其中约28%(总数1.4%)会发子痫[9]。发达国家因为医疗的改善,每2000名产妇约有1名会得到子痫[1]。妊娠高血压是怀孕期最常见的死因之一[10]。2013年因妊娠高血压死亡的人数为二万九千人,较1990年的三万七千人要少[11]。患有子痫的女性中,约有1%因此死亡[1]。
参考资料
编辑- ^ 1.0 1.1 1.2 1.3 1.4 1.5 40. Williams obstetrics 24th. McGraw-Hill Professional. 2014. ISBN 9780071798938.
- ^ Lambert, G.; Brichant, J. F.; Hartstein, G.; Bonhomme, V.; Dewandre, P. Y. Preeclampsia: an update. Acta Anaesthesiologica Belgica. 2014, 65 (4): 137–149 [2020-12-24]. ISSN 0001-5164. PMID 25622379. (原始内容存档于2021-02-28).
- ^ American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and Gynecology. 2013-11, 122 (5): 1122–1131 [2020-12-24]. ISSN 1873-233X. PMID 24150027. doi:10.1097/01.AOG.0000437382.03963.88. (原始内容存档于2020-11-21).
- ^ Mohler, Emile R.; Townsend, Raymond R. Advanced Therapy in Hypertension and Vascular Disease. PMPH-USA. 2006: 407–408 [2016-03-09]. ISBN 978-1-55009-318-6. (原始内容存档于2015-10-05) (英语).
- ^ WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. (PDF). 2011 [2016-03-09]. ISBN 978-92-4-154833-5. (原始内容存档 (PDF)于2015-05-13).
- ^ Henderson, Jillian T.; Whitlock, Evelyn P.; O'Connor, Elizabeth; Senger, Caitlyn A.; Thompson, Jamie H.; Rowland, Maya G. Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force. Annals of Internal Medicine. 2014-05-20, 160 (10): 695–703 [2020-12-24]. ISSN 1539-3704. PMID 24711050. doi:10.7326/M13-2844. (原始内容存档于2020-09-03).
- ^ 7.0 7.1 Smith, Jeffrey Michael; Lowe, Richard F.; Fullerton, Judith; Currie, Sheena M.; Harris, Laura; Felker-Kantor, Erica. An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management. BMC pregnancy and childbirth. 2013-02-05, 13: 34 [2020-12-24]. ISSN 1471-2393. PMC 3570392 . PMID 23383864. doi:10.1186/1471-2393-13-34. (原始内容存档于2022-01-09).
- ^ McDonald, Sarah D.; Lutsiv, Olha; Dzaja, Nancy; Duley, Lelia. A systematic review of maternal and infant outcomes following magnesium sulfate for pre-eclampsia/eclampsia in real-world use. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics. 2012-08, 118 (2): 90–96 [2020-12-24]. ISSN 1879-3479. PMID 22703834. doi:10.1016/j.ijgo.2012.01.028. (原始内容存档于2021-12-21).
- ^ Abalos, Edgardo; Cuesta, Cristina; Grosso, Ana L.; Chou, Doris; Say, Lale. Global and regional estimates of preeclampsia and eclampsia: a systematic review. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2013-09, 170 (1): 1–7 [2020-12-24]. ISSN 1872-7654. PMID 23746796. doi:10.1016/j.ejogrb.2013.05.005. (原始内容存档于2021-03-08).
- ^ Arulkumaran, N.; Lightstone, L. Severe pre-eclampsia and hypertensive crises. Best Practice & Research. Clinical Obstetrics & Gynaecology. 2013-12, 27 (6): 877–884 [2020-12-24]. ISSN 1532-1932. PMID 23962474. doi:10.1016/j.bpobgyn.2013.07.003. (原始内容存档于2020-09-02).
- ^ GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England). 2015-01-10, 385 (9963): 117–171 [2020-12-24]. ISSN 1474-547X. PMC 4340604 . PMID 25530442. doi:10.1016/S0140-6736(14)61682-2. (原始内容存档于2021-03-08).