Skip to main content
Mijn bibliotheek
Shop
Nieuws Boeken Tijdschriften E-learning Web-tv Video Audio
Tips voor Mijn BSL
UITGEBREID ZOEKEN
Inloggen
Top
Bijblijven
Gepubliceerd in: Bijblijven 2/2003

01-02-2003 | Artikelen

Hypertensie en zwangerschapzwangerschap hypertensie

Auteur: Dr. W. Visser

Gepubliceerd in: Bijblijven | Uitgave 2/2003

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail
    Link delen
publish
Publiceer nu

Samenvatting

Hypertensie is een veelvoorkomend probleem tijdens zwangerschap. Naast chronische hypertensie kan er ook sprake zijn van zwangerschapshypertensie of pre-eclampsie. Bij hypertensieve vrouwen met zwangerschapswens dient men na te gaan of er verschijnselen zijn van secundaire orgaanschade en bij ernstige hypertensie dient een secundaire vorm van hypertensie te worden uitgesloten. Antihypertensieve behandeling is in ieder geval geïndiceerd bij een ernstige hypertensie (= 170/110 mmHg) om directe schade aan de moederlijke vaten te voorkomen.
Met antihypertensieve behandeling bij milde tot matige hypertensie vermindert men de incidentie van ernstige hypertensie, maar het is nog onduidelijk of behandeling zinvol dan wel nadelig is voor de perinatale uitkomst. Methyldopa is een veelgebruikt en bewezen veilig middel tijdens zwangerschap. Nifedipine lijkt een goed alternatief, maar onderzoek naar mogelijke langetermijneffecten bij het blootgestelde kind ontbreken nog. Ook bètablokkers worden vaak gebruikt, maar hebben mogelijk een negatief effect op de foetale groei.
Het door de zwangerschap geïnduceerde hypertensiesyndroom vormt een ziektebeeld met een gevarieerd maar veelal progressief beloop, waarvoor uitsluitend beëindiging van de zwangerschap genezing kan bieden. Zodra er sprake is van pre-eclampsie is klinische observatie aangewezen. Elke zwangere met klachten van pijn in de rechter bovenbuik, epigastrio of hoog in de rug, in de tweede helft van de zwangerschap, moet worden onderzocht op de aanwezigheid van het hellp-syndroom. Ernstige pre-eclampsie, eclampsie en hellp kunnen levensbedreigend zijn voor moeder en kind. Het herhalingsrisico van het optreden van pre-eclampsie in een volgende zwangerschap is 18%. Met een lage dosis aspirine, vanaf een zwangerschapsduur van twaalf weken, kan men de kans op pre-eclampsie iets verminderen.
vorige artikel Hypertensie bij allochtonen in Nederland
volgende artikel Natuurlijk beloop van de bloeddruk en ontwikkeling van hypertensie
Voetnoten
1
Davey DA, MacGillivray I. The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol 1988;158:892-8.
 
2
Brown MA, Lindheimer MD, Swiet M de, Assche A van, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: Statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertension in Pregnancy 2001;20:ix-xiv.
 
3
Higgins JR, Swiet M de. Blood-pressure measurement and classification in pregnancy. Lancet 2001;357:131-5.
 
4
Magee LA. Antihypertensives. Best Pract Res Clin Obstet Gynaecol 2001;15:827-45.
 
5
Sibai BM. Chronic hypertension in pregnancy. Obstet Gynecol 2002;100:369-77.
 
6
Magee LA. Antihypertensives. Best Pract Res Clin Obstet Gynaecol 2001;15:827-45.
 
7
Sibai BM. Chronic hypertension in pregnancy. Obstet Gynecol 2002;100:369-77.
 
8
Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. The Cochrane Library 2003;Issue1.
 
9
Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. The Cochrane Library 2002;Issue 4.
 
10
Sibai BM. Chronic hypertension in pregnancy. Obstet Gynecol 2002;100:369-77.
 
11
Magee LA. Antihypertensives. Best Pract Res Clin Obstet Gynaecol 2001;15:827-45.
 
12
Sibai BM. Chronic hypertension in pregnancy. Obstet Gynecol 2002;100:369-77.
 
13
Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. The Cochrane Library 2003;Issue1.
 
14
Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. The Cochrane Library 2002;Issue 4.
 
15
Gallery EDM. Chronic essential and secondary hypertension in pregnancy. Best Pract Res Clin Obstet Gynaecol 1999;13:15-30.
 
16
Magee LA. Antihypertensives. Best Pract Res Clin Obstet Gynaecol 2001;15:827-45.
 
17
Sibai BM. Chronic hypertension in pregnancy. Obstet Gynecol 2002;100:369-77.
 
18
Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. The Cochrane Library 2003;Issue1.
 
19
Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. The Cochrane Library 2002;Issue 4.
 
20
Gallery EDM. Chronic essential and secondary hypertension in pregnancy. Best Pract Res Clin Obstet Gynaecol 1999;13:15-30.
 
21
Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. The Cochrane Library 2003;Issue1.
 
22
Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. The Cochrane Library 2002;Issue 4.
 
23
Magee LA. Antihypertensives. Best Pract Res Clin Obstet Gynaecol 2001;15:827-45.
 
24
Gallery EDM. Chronic essential and secondary hypertension in pregnancy. Best Pract Res Clin Obstet Gynaecol 1999;13:15-30.
 
25
Ounsted M, Cockburn J, Moar VA, Redman CWG. Maternal hypertension with superimposed pre-eclampsia: Effects on child development at 7½ years. Br J Obstet Gynaecol 1983;90:644-9.
 
26
Magee LA. Antihypertensives. Best Pract Res Clin Obstet Gynaecol 2001;15:827-45.
 
27
Sibai BM. Chronic hypertension in pregnancy. Obstet Gynecol 2002;100:369-77.
 
28
Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. The Cochrane Library 2003;Issue1.
 
29
Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. The Cochrane Library 2002;Issue 4.
 
30
Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. The Cochrane Library 2003;Issue1.
 
31
Magee LA, Schick B, Donnenfeld AE, Sage SR, Conover B, Cook L, et al. The safety of calcium channel blockers in human pregnancy: A prospective, multicenter cohort study. Am J Obstet Gynecol 1996;174:823-8.
 
32
Bartolus R, Ricci E, Chatenoud L, Parazzini F. Nifedipine administration in pregnancy: Effect on the development of children at 18 months. Br J Obstet Gynaecol 2000;107:792-4.
 
33
Piper JM, Wayne AR, Franz WR. Pregnancy outcome following exposure to angiotensin-converting enzyme inhibitors. Obstet Gynecol 1002;80:429-32.
 
34
Martinovic J, Benachi A, Laurent N, Daïkha-Dahmane F, Gubler MC. Fetal toxic effects and angiotensin-II-receptor antagonist. Lancet 2001;358:241.
 
35
Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Eng J Med 2002;346:752-763.
 
36
Visser W, Wallenburg HCS. Central hemodynamic observations in untreated preeclamptic patients. Hypertension 1999;17:1072-7.
 
37
Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: A severe consequence of hypertension in pregnancy. Am J Obstet Gynecol 1982;142:159-67.
 
38
Visser W, Wallenburg HCS. Temporising management of severe pre-eclampsia with and without the HELLP syndrome. Br J Obstet Gynaecol 1995;102:111-7.
 
39
Magpie Trial Collaborative Group. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: A randomised placebo-controlled trial. Lancet 2002;359:1877-90.
 
40
The Eclampsia Trial Collaborative Group. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 1995;345:1455-63.
 
41
Vaughan CJ, Delanty N. Hypertensive emergencies. Lancet 2000;356:411-7.
 
42
Visser W. Hemodynamic effects of plasma expansion and vasodilatation in preeclamptic patients. In: Hemodynamic studies in preeclampsia: Implications for management. Proefschrift. Rotterdam: Erasmus Universiteit Rotterdam 1995;57-68.
 
43
Duley L, Henderson-Smart DJ. Drugs for treatment of very high blood pressure during pregnancy. The Cochrane Library 2002;Issue 4.
 
44
Pampus MG van, Wolf H, Mayruhu G, Treffers PE, Bleker OP. Long-term follow-up in patients with a history of (h)ellp syndrome. Hypertens Pregnancy. 2001;20(1):15-23.
 
45
Visser W, Wallenburg HCS. Prediction and prevention of pregnancy induced hypertensive disorders. Best Pract Res Clin Obstet Gynaecol 1999;13:131-56.
 
46
Visser W, Wallenburg HCS. Prediction and prevention of pregnancy induced hypertensive disorders. Best Pract Res Clin Obstet Gynaecol 1999;13:131-56.
Knight M, Duley L, Henderson-Smart DJ, King JF. Antiplatelet agents for preventing and treating pre-eclampsia. The Cochrane Library 2003;Issue 1.
Dekker G, Sibai B. Primary, secondary and tertiary prevention of pre-eclampsia. Lancet 2001;357:209-15.
 
47
Knight M, Duley L, Henderson-Smart DJ, King JF. Antiplatelet agents for preventing and treating pre-eclampsia. The Cochrane Library 2003;Issue 1.
 
48
Knight M, Duley L, Henderson-Smart DJ, King JF. Antiplatelet agents for preventing and treating pre-eclampsia. The Cochrane Library 2003;Issue 1.
 
49
Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, Fait G, Lessing JB. Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Eng J Med 1999;340:9-13.
 
50
Chappel LC, Seed PT, Briley AL, Kelly FJ, Lee R, Hunt BJ et al. Effects of antioxidants on the occurrence of pre-eclampsia in women at increased risk: A randomised trial. Lancet 1999;354:810-6.
 
51
Dekker G, Sibai B. Primary, secondary and tertiary prevention of pre-eclampsia. Lancet 2001;357:209-15.
 
Literatuur
Davey DA, MacGillivray I. The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol 1988;158:892-8.PubMed
Brown MA, Lindheimer MD, Swiet M de, Assche A van, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: Statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertension in Pregnancy 2001;20:ix-xiv.PubMed
Higgins JR, Swiet M de. Blood-pressure measurement and classification in pregnancy. Lancet 2001;357:131-5.CrossRefPubMed
Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. The Cochrane Library 2003;Issue1.
Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. The Cochrane Library 2002;Issue 4.
Gallery EDM. Chronic essential and secondary hypertension in pregnancy. Best Pract Res Clin Obstet Gynaecol 1999;13:15-30.CrossRef
Ounsted M, Cockburn J, Moar VA, Redman CWG. Maternal hypertension with superimposed pre-eclampsia: Effects on child development at 7½ years. Br J Obstet Gynaecol 1983;90:644-9.PubMed
Magee LA, Schick B, Donnenfeld AE, Sage SR, Conover B, Cook L, et al. The safety of calcium channel blockers in human pregnancy: A prospective, multicenter cohort study. Am J Obstet Gynecol 1996;174:823-8.CrossRefPubMed
Bartolus R, Ricci E, Chatenoud L, Parazzini F. Nifedipine administration in pregnancy: Effect on the development of children at 18 months. Br J Obstet Gynaecol 2000;107:792-4.
Piper JM, Wayne AR, Franz WR. Pregnancy outcome following exposure to angiotensin-converting enzyme inhibitors. Obstet Gynecol 1002;80:429-32.
Martinovic J, Benachi A, Laurent N, Daïkha-Dahmane F, Gubler MC. Fetal toxic effects and angiotensin-II-receptor antagonist. Lancet 2001;358:241.CrossRefPubMed
Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Eng J Med 2002;346:752-763.CrossRef
Visser W, Wallenburg HCS. Central hemodynamic observations in untreated preeclamptic patients. Hypertension 1999;17:1072-7.
Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: A severe consequence of hypertension in pregnancy. Am J Obstet Gynecol 1982;142:159-67.PubMed
Visser W, Wallenburg HCS. Temporising management of severe pre-eclampsia with and without the HELLP syndrome. Br J Obstet Gynaecol 1995;102:111-7.PubMed
Magpie Trial Collaborative Group. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: A randomised placebo-controlled trial. Lancet 2002;359:1877-90.
The Eclampsia Trial Collaborative Group. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 1995;345:1455-63.
Visser W. Hemodynamic effects of plasma expansion and vasodilatation in preeclamptic patients. In: Hemodynamic studies in preeclampsia: Implications for management. Proefschrift. Rotterdam: Erasmus Universiteit Rotterdam 1995;57-68.
Duley L, Henderson-Smart DJ. Drugs for treatment of very high blood pressure during pregnancy. The Cochrane Library 2002;Issue 4.
Pampus MG van, Wolf H, Mayruhu G, Treffers PE, Bleker OP. Long-term follow-up in patients with a history of (h)ellp syndrome. Hypertens Pregnancy. 2001;20(1):15-23.PubMed
Visser W, Wallenburg HCS. Prediction and prevention of pregnancy induced hypertensive disorders. Best Pract Res Clin Obstet Gynaecol 1999;13:131-56.CrossRef
Knight M, Duley L, Henderson-Smart DJ, King JF. Antiplatelet agents for preventing and treating pre-eclampsia. The Cochrane Library 2003;Issue 1.
Dekker G, Sibai B. Primary, secondary and tertiary prevention of pre-eclampsia. Lancet 2001;357:209-15.CrossRefPubMed
Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, Fait G, Lessing JB. Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Eng J Med 1999;340:9-13.CrossRef
Chappel LC, Seed PT, Briley AL, Kelly FJ, Lee R, Hunt BJ et al. Effects of antioxidants on the occurrence of pre-eclampsia in women at increased risk: A randomised trial. Lancet 1999;354:810-6.
Metagegevens
Titel
Hypertensie en zwangerschapzwangerschap hypertensie
Auteur
Dr. W. Visser
Publicatiedatum
01-02-2003
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Bijblijven / Uitgave 2/2003
Print ISSN: 0168-9428
Elektronisch ISSN: 1876-4916
DOI
https://doi.org/10.1007/BF03059688

Andere artikelen Uitgave 2/2003

Bijblijven 2/2003 Naar de uitgave

Artikelen

Hypertensie bij allochtonen in Nederland

Artikelen

Vetstofwisselingsafwijkingen bij kinderenfamiliaire hypercholesterolemie cholesterol

Artikelen

Secundaire en maligne hypertensiehypertensie

Artikelen

De winst van hypertensiebehandeling

Artikelen

Bloeddrukmeting: technieken en methoden

Artikelen

Homocysteïne: een nieuwe risicofactor voor hart- en vaatziektenHomocysteïne