臨床婦人科産科62巻4号

2008年04月発行

今月の臨床 産婦人科臨床の難題を解く─私はこうしている I 周産期管理 【妊娠管理】

8.妊娠高血圧症候群の降圧薬の選択は？

著者： 山崎峰夫¹

所属機関： ¹神戸大学医学部産科婦人科学教室

ページ範囲：P.398 - P.403

1 はじめに

　妊娠高血圧症候群（pregnancy induced hypertension : PIH）妊婦に対する降圧薬療法は，母体臓器障害の防止が第一の目的である．一方の胎児にとっては，加療により妊娠が継続できれば体重増・成熟というメリットがある反面，血圧降下による子宮胎盤血流量の減少が生ずれば生理機能に障害が起こるというデメリットがある．降圧治療の実施にあたっては，個々の症例における降圧治療の目的と適応を十分に評価すること，開始後も刻々と変化する母児の状態を常にモニターして適切な分娩時期を失することのないよう管理することが求められる．また，使用する降圧薬の母児に及ぼす作用についてよく理解することも重要である．

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