子癇

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子癇
分类和外部资源
醫學專科英语Specialty (medicine) 產科學
ICD-10 O15
ICD-9 642.6
DiseasesDB 4068
MedlinePlus 000899
EMedicine med/1905 emerg/796
Patient UK英语Patient UK 子癇
MeSH D004461

子癇英语:Eclampsia)是指孕婦因為妊娠毒血症而產生的癲癇英语Epileptic seizure症狀[1]。妊娠毒血症是在妊娠期間的疾病,其症狀為高血壓蛋白尿或其他器官功能的異常[2][3]。子癇可能會在分娩前、分娩中或分娩後發生。子癇的癲癇是屬於強直-陣攣性發作,約會持續一分鐘。在癲癇後可能會處於癲癇發作后狀態英语Postictal state或是昏迷。併發症有吸入性肺炎英语Aspiration pneumonia腦出血腎功能衰竭或是心搏停止。妊娠毒血症及子癇都可歸類為妊娠高血壓英语Hypertensive disease of pregnancy[1]

字源及歷史[编辑]

英语:eclampsia源自希腊语ἐκλαμψίαeklampsía,意為閃電隱喻其短暫爆發的特性)。第一個有關子癇症狀的描述是在西元前五世紀的希波克拉底[4]

預防及治療方式[编辑]

建議的預防方式如下:高風險者服用阿斯匹靈,若鈣質攝取量不足,使用鈣質補充劑,針對早期的高血壓給予藥物治療[5][6]。在懷孕期間運動也會有幫助[1]。若有子癇症狀,肌肉注射或靜脈注射硫酸鎂可改善症狀,一般來說是安全的[7][8],在已開發國家開發中國家都適用[7]。可能也需要設備來輔助呼吸,其他的治療包括高血壓藥物肼屈嗪以及用陰道分娩或是剖宮產方式緊急將胎兒生下[1]

流行病學,預後[编辑]

產婦中約有5%會得到妊娠毒血症,而子癇的產婦中約佔1.4%[9]。已開發國家因為醫療的改善,每2000名產婦約有1名會得到子癇[1]。妊娠高血壓是懷孕期最常見的死因之一[10]。2013年因妊娠高血壓死亡的人數為二萬九千人,較1990年的三萬七千人要少[11]。患有子癇的女性中,約有約有1%因此死亡[1]

參考資料[编辑]

  1. ^ 1.0 1.1 1.2 1.3 1.4 1.5 40. Williams obstetrics 24th. McGraw-Hill Professional. 2014. ISBN 9780071798938. 
  2. ^ Lambert, G; Brichant, JF; Hartstein, G; Bonhomme, V; Dewandre, PY. Preeclampsia: an update.. Acta anaesthesiologica Belgica. 2014, 65 (4): 137–49. PMID 25622379. 
  3. ^ Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. (PDF). Obstet Gynecol. Nov 2013, 122 (5): 1122–31. doi:10.1097/01.AOG.0000437382.03963.88. PMID 24150027. 
  4. ^ Emile R. Mohler. Advanced Therapy in Hypertension and Vascular Disease. PMPH-USA. 2006: 407–408. ISBN 9781550093186. 
  5. ^ WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. (PDF). 2011. ISBN 978-92-4-154833-5. 
  6. ^ Henderson, JT; Whitlock, EP; O'Connor, E; Senger, CA; Thompson, JH; Rowland, MG. 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. May 20, 2014, 160 (10): 695–703. doi:10.7326/M13-2844. PMID 24711050. 
  7. ^ 7.0 7.1 Smith, JM; Lowe, RF; Fullerton, J; Currie, SM; Harris, L; Felker-Kantor, E. An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management.. BMC pregnancy and childbirth. 5 February 2013, 13: 34. PMID 23383864. 
  8. ^ McDonald, SD; Lutsiv, O; Dzaja, N; Duley, L. 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. August 2012, 118 (2): 90–6. PMID 22703834. 
  9. ^ Abalos, E; Cuesta, C; Grosso, AL; Chou, D; Say, L. Global and regional estimates of preeclampsia and eclampsia: a systematic review.. European journal of obstetrics, gynecology, and reproductive biology. September 2013, 170 (1): 1–7. PMID 23746796. 
  10. ^ Arulkumaran, N.; Lightstone, L. Severe pre-eclampsia and hypertensive crises. Best Practice & Research Clinical Obstetrics & Gynaecology. December 2013, 27 (6): 877–884. doi:10.1016/j.bpobgyn.2013.07.003. 
  11. ^ 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. 17 December 2014. doi:10.1016/S0140-6736(14)61682-2. PMID 25530442.