Pregnancy complications tip of the iceberg.

Gestational hypertension during pregnancy is unique to the disease, a serious impact on maternal and child health, maternal and perinatal mortality of the main reasons.

Hypertension for men and women are one of the most important cardiovascular risk factors. In the pathogenesis of its men and women in many of the common, although the mechanism of hypertension are not aware of the many. Women because of their unique physiology of female patients with hypertension and there are certain aspects of male patients with hypertension different characteristics. Women's blood pressure by age, menstrual cycle, fertility drugs, and the multifaceted impact, high blood pressure more complex than men, and should be treated more carefully. The epidemiological investigation of the 24-hour ambulatory blood pressure testing found: In premenopausal women, men over the age of women with high blood pressure, and this difference disappeared in postmenopausal women, even women blood pressure more than men, while the incidence of cardiovascular disease also Increased significantly. On the mechanism of this phenomenon, is now widely recognized before and after menopause is caused by changes in hormones, in addition, some people think that with the arterial tree, post-menopausal women before and after the change of the salt-sensitive. This paper will be women and hypertension-related physiological and pathological and physiological characteristics of women's characteristics and the treatment of hypertension to be reviewed.

1, the menstrual cycle

Research shows that the earlier the age at menarche, the greater the risk factors of hypertension. Obesity is generally an earlier menarche, obesity risk of hypertension. Follicular phase, including the menstrual cycle, ovulation period and the luteal phase, during which estrogen levels are constant fluctuations. In different menstrual cycle, because of stress factors to stimulate, estrogen can reduce the secretion of catecholamine to influence the excitement of the sympathetic nervous system, lower blood pressure, blood vessels and can reduce tension and vascular resistance to prevent cardiovascular disease in women , The follicular phase diastolic blood pressure than the luteal phase was increased.

2, the pill

Use of oral antihypertensive drug for women of their systolic and diastolic blood pressure than the use of other contraceptive methods and not taking oral contraceptives for women have served, and oral contraceptives can weaken the antihypertensive effect of antihypertensive drugs, the use of oral antihypertensive drugs The women, blood pressure is also difficult to control, often in the show to severe hypertension, even intractable hypertension.

Epidemiological investigations revealed that the use of oral contraceptives and hypertension poor control of blood pressure has a lot, so when taking oral antihypertensive drugs in patients with hypertension women an independent risk factor, and not dependent on age, weight and antihypertensive drugs, and other factors. Stop service contraceptives, blood pressure in the short term is to normal, but no longer rising. It is worth mentioning that: oral contraceptives not only allows a very small number of normal blood pressure of female high blood pressure, high blood pressure but also allows the original condition of women increased, but also to have high blood pressure and family history of the past are pregnant with high occurrence of hypertension, . In case of the above, should be switched to other contraceptive measures.

3, hypertension during pregnancy

Pregnancy-induced hypertension (PIH) is defined as 20 weeks of pregnancy, pregnant women in high blood pressure, edema and proteinuria called pregnancy-induced hypertension. One of hypertension refers to high blood pressure ≥ 140/90 mmHg, or blood pressure than Yunqian early pregnancy or high blood pressure ≥ 25/15 mmHg. Because many normal pregnancy, as well as edema, it may also edema out its definition. If only high blood pressure, without proteinuria there, known as pregnancy-induced hypertension, multiple pregnancy after the end of that blood pressure can quickly return to this part of patients.

Gestational hypertension during pregnancy is unique to the disease, a serious impact on maternal and child health, maternal and perinatal mortality of the main reasons. Epidemiological survey found that early maternal, pregnant women aged <18 years or> 40-year-old, multiple pregnancy, pregnancy history of hypertension and family history, chronic high blood pressure, chronic nephritis, antiphospholipid syndrome, diabetes, angiotensin-positive gene T235 , Malnutrition, low socio-economic situation, increase in the risk of hypertension during pregnancy. Its cause has not yet been clarified, on its etiology of obstetrics is always hot. In recent years, as molecular biology, immunology and molecular genetics of progress, domestic and foreign scholars from a deeper level of theoretical perspectives on a variety of theories, the theory of PIH cause of research and understanding of the pathogenesis of the disease Is of great significance. The main theory is: ① immunity doctrine; ② said genetics; ③ endothelial cell activation and injury doctrine; ④ placental trophoblast cells or ischemia theory; ⑤ oxidative stress theory; ⑥ leptin and PIH.

To sum up, according to the latest research, from the perspective of their immune and genetic causes of disease mechanisms and unified explanation, that is due to lead to genetic mother to fetus nourishment of the low-antigen recognition, the protective immune response weakened and rejection Enhanced so that the trophoblast cells of the damage, and the decline in infiltration capacity placenta shallow implantation, then the placenta from hypoxia ischemia, and enhance the local cellular immune response, a partial placenta oxidative stress, manifested as lipid peroxidation and release oxygen Free radicals, while the release of a large number of inflammatory cytokines, activated neutrophils, directly or indirectly lead to vascular endothelial injury, eventually triggered PIH.

On the diseases buck gestational hypertension treatment, and can not prevent pre-eclampsia occur and improve the fetus delivered, because the incidence of preeclampsia was not caused by high blood pressure and blood pressure will lead to lower his head and uterine insufficiency, but When high blood pressure, antihypertensive treatment is very necessary.

Antihypertensive treatment of chronic hypertension in pregnancy if the former is to use multiple drugs can continue to use, but attention should be paid to the adverse drug reaction. Pregnancy-induced hypertension, if not very high blood pressure, such as hypertension and second-class, high blood pressure patients are not the target organ damage, can not actively buck, because there is no evidence that antihypertensive drugs can improve the prognosis of newborns