thuốc điều trị tăng huyết áp ở phụ nữ có thai

   
    
  
        

 
 
   !" 
 



  
 




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   
    
     
Ph n mang thai nên kim
tra huyt áp thng xuyên.
          !" # 
  
   
    !"#  !" $% & '! !( )*
+
 ,& '!-!.( !/ #
0 1-!(2 . 3 !.( 4 5! *1#/

& *67#( *#8
0 -"* 9: )# 
 $ %      !!" # 
  ≥ ;<=><*!
 ?
0   @! AB<**!
0  @! A**!
C5D ED F */! /
#$     % 
(Gestational Hypertension)
7 G ED < H /
!(2 . " I<
G ) ?! $2 F */! /
G )   !"
          &  '      (
J G 9. K !  *6G K " F& L9  
*/! / 5M   G 9NK
PREGNANCY INDUCED
HYPERTENSION (PIH)
Chronic Hypertension
in Pregnancy
30% 70%
 )  * +
O + K H 2
/ < H /
E/P !(2 .
G ) !.( #  !"
 ) ,       
 Q% & '! ER! !?9 I< 
 !(2 . */! / & '''

S (&-
0 T* U *:
0 T  0  (
0 S * V
0 + . W! *X/ Y /($ S.( *6
 Z E[! /6!
 J G  #T & FG $ER!
 !( )* & 3 *6!  9\ 5% / 
 .($% ! : !(2 . 3 !.( 4 5! *1
 ] $K *^! : !/ 6$% -
B:! H- #!_/-` #-ab
()% *  +
#, $ )% *  +
  /
 c 
 NK
 
 0 
 
 NK
d :
()% *  +
1 2 0 )% *  +
3/ * (4(
e 4* 5
 56789 :9;<=% >$  ?
e 4* @ 
 A B
C @ 7D 5E7F9 779;;$>
0 7G

C @ HD 567F9 779; %I I;
$>0 HG
e 4* #
"A BDJ2 0 $B
!!
4


# 5

3(#
 \ 2  -
0 S * & '! 5D *1
0 S_ /% /  & F / Rf
- Không nên h huyt áp quá tích cc s làm gim ti máu cho
nhau thai và nh hng n s phát trin ca thai nhi
Qg . ^$L 3 5% !( [ h/ 
iu tr tng huyt áp nng bao gm kim soát tt
huyt áp bng các thuc h áp ng tnh mch và c
gng duy trì quá trình thai nghén n mc ti a mà
không gây nh hng gì n m và thai nhi.

(%    # 5
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i N
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 !N0 $N
 & N
i jk
 $FN
 & Nl(*
()  mjk
/99$#8
 F:! \ )
h/  !N
 i ,k
Q//#8f
 K  5#L
Gây h huyt áp, suy thn cp, quá d tha kali và thm chí
t vong cho  mi sinh
 S / Fn-2 ;,+( G a " /f
E/G 6U! ' @! h/ ! "f
 S 0B/ Fn-7 G 6U! ' @! h/ !
"
2 b,c!  mj ! `H +( G
 5g K#; :3f

 mj G $2 o/ D-C( "#&#) @!
"#! *   9Zf
  ! 5% Bh/ / Fn
The Michigan Medicaid Surveillance Program
 K  >
 p! E 
' &  m#
 ' & \
)  !N
MCk#
 $FN 
 ! 
5% Bh/ / Fn
Aliskiren C (use during first trimester)
D (use during second and third trimesters) by the FDA
Michigan Medicaid Surveillance Program
0 !2 ' 2 U! 5" F: 2 !ER
0  / 2 5% \ D 5% @* ,
0 U  ER! L9 c!   2 Fg! Fq!
^^ !(2 . !.( /  ri  $%  %
,W! '! 5 : \!#: \! Fg! *! *
Fg! " P %!
!!!

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



# 5


3(#
European Network of Teratology Information Services
(ENTIS)
Food and Drug Administration (FDA)
#N  O 

 & Z! L9 /N$/*
 P L  Q R1  35
  H /(   
*6 
 7 -/%     9\
5% / 
 rc!  ! D* 5% *U h/
/ Fn
   1 5% 5s/
  : \! 9\
  L9 EL c! hydralazin,
beta-blockers, ? nifedipin
#? <S T
 7 G /! .*-/%
    9\ 5% / 
 rc!  ! D* 5% *U h/
/ Fn
   [ ? ( M
 rc! ! tN9k?
2* nicardipink
  : \! 9\
#? U>$ A%
Decreased fetal

growth with
atenolol
Atenolol vs placebo1629*Butters et al
27
First trimester use of atenolol has been associated with an
increased incidence (11.4%) of birth defects
Michigan Medicaid Surveillance Program
Food and Drug Administration (FDA)
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