High blood pressure isn't only a risk during pregnancy

By Joyce Tsai, American Heart Association News

Christina Roberto and her daughter, Charlotte, who is now 2. (Photo courtesy of Christina Roberto)
Christina Roberto and her daughter, Charlotte, who is now 2. (Photo courtesy of Christina Roberto)

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在经历了一段艰难的怀孕,伴随着严重的恶心和呕吐之后, 克里斯蒂娜·罗伯托(Christina Roberto)回忆起两年前她终于带着刚出生的女儿来到这里时那种压倒性的解脱感, Charlotte, safely home from the hospital.

"It was a really stressful pregnancy," she said. “所以和夏洛特一起回家的时候,我感到如释重负——想着每个人都很安全,都过得很好."

That feeling wouldn't last for long. 在照顾她的新生儿大约一周后,罗伯托出现了不寻常的头痛和胃痛. With a home monitoring kit, 她量了血压,惊讶地发现它高达180/110毫米汞柱.

她打电话给一位朋友,一位急诊医生,他建议她去急诊室. There, Roberto learned that she had postpartum preeclampsia, 一种导致高血压并可能导致其他器官功能不正常的疾病. The diagnosis came as a shock because she'd never had high blood pressure, not even during her pregnancy.

罗伯托是每年成千上万的产后高血压妇女之一, even though they never had a history of high blood pressure, also known as hypertension.

In fact, 近八分之一的新妈妈可能在分娩后的一年内患上高血压,其中约五分之一的人在分娩后超过六周就患上高血压, 根据去年发表在美国心脏协会杂志上的一项研究 Hypertension. 风险最高的人群是年龄在35岁以上、剖腹产过、现在或以前吸烟的人. But experts say it can strike anyone, even those without obvious risk factors.

Postpartum hypertension can be serious and life-threatening if left untreated. 严重的病例与中风、心力衰竭、癫痫和肾衰竭有关.

高血压和先兆子痫最常见于分娩后的头两周. Elizabeth Langen, 她是密歇根大学安娜堡分校妇产科副教授和心脏产科项目的联合主任.

That's why it's important, she said, 所有的新妈妈都知道要在分娩后的几周或几个月里寻找高血压和先兆子痫的迹象和症状. They can include a systolic (top number) blood pressure reading of 140 mmHg or higher or a diastolic (bottom number) reading of 90 mmHg or higher; blurry vision or seeing spots; a persistent headache; and shortness of breath. An over-the-counter blood pressure monitor allows women to check their blood pressure at home, as Roberto did.

If new mothers experience such symptoms, 她们应该得到一个知道她们最近怀孕的卫生保健专业人员的评估, 特别是如果他们去急诊或急诊室,否则可能会增加更严重并发症甚至死亡的风险, Langen said.

The American College of Obstetricians and Gynecologists advises new mothers to get a health checkup within three weeks of delivery, with additional visits scheduled as needed. 对于怀孕期间患有高血压的女性来说,第一次检查应该在分娩后3到10天内进行.

For mothers who learn they have hypertension or preeclampsia postpartum, "it can be a very stressful and almost traumatic event, 因为他们认为自己没有危险,他们没有意识到分娩后会发生这样的事情," said Dr. Jennifer Lewey, 她是宾夕法尼亚大学医院的心脏病专家,也是宾夕法尼亚妇女心血管健康项目的主任.

For Roberto, it gave rise to another condition: postpartum anxiety.

"You're just very sad, because it's this fragile time where your hormones are raging," she said, "and you are thinking, 'Am I going to just stroke out and die? I need to live. I need to be here for my kid.'"

全国各地越来越多的项目每天远程监测新妈妈们的血压几次, like at the University of Pennsylvania Health System, where Roberto enrolled after her diagnosis. But experts say more needs to be done to implement these programs nationwide, 以及教育所有医生如何检测和治疗这些疾病.

Roberto, 宾夕法尼亚大学医学院医学伦理与卫生政策副教授, 她说,如果不采取更多措施来教育和培养对这个问题的认识,她担心许多其他女性可能会像她一样措手不及.

“没有人跟我说过这件事,也没有人警告过我,”她说. "I was lucky to get the help I did, but I can't imagine that for the average mom giving birth, this is on her radar. But if it were, it could really be lifesaving."

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