Twin pregnancies with chronic hypertension and sleep apnea-hypopnea syndrome treated with continuous positive airway pressure: report of three cases
10.3760/cma.j.cn113903-20230923-00229
- VernacularTitle:持续气道正压通气治疗慢性高血压合并睡眠呼吸暂停低通气综合征的双胎孕妇3例
- Author:
Xiao LYU
1
;
Jingyu WANG
;
Jun WEI
;
Jingjing YANG
;
Fang HAN
;
Guoli LIU
Author Information
1. 北京大学人民医院妇产科，北京 100044
- Keywords:
Hypertension;
Sleep apnea, obstructive;
Continuous positive airway pressure;
Pregnancy, twin
- From:
Chinese Journal of Perinatal Medicine
2024;27(3):241-244
- CountryChina
- Language:Chinese
-
Abstract:
This paper reports the maternal and fetal outcomes of three twin pregnancies with chronic hypertension and obstructive sleep apnea-hypopnea syndrome (OSAHS) who were treated with continuous positive airway pressure (CPAP). All three women with twin pregnancies were diagnosed with chronic hypertension. Furthermore, symptoms such as snoring and apnea assisted the diagnosis of OSAHS through polysomnography monitoring. Case 1 was treated with CPAP at 28 gestational weeks. The blood pressure increased gradually after the first month of CPAP treatment, with an elevated urine protein concentration. At 34 gestational weeks, the pregnant woman underwent a cesarean section due to the development of hemolysis, elevated liver enzymes, and low platelet syndrome. Case 2 was treated with CPAP at 11 gestational weeks, with stable blood pressure throughout the pregnancy, and was delivered through cesarean section at 37 weeks of pregnancy. Case 3 started CPAP at 13 gestational weeks for four months, and increased blood pressure and urine protein were observed. Medication brought the blood pressure down, and urine protein became negative. At 32 gestational weeks, a cesarean section was performed because of premature rupture of the membrane. Her CPAP treatment continued till delivery with good maternal and infant outcomes. The treatment outcomes of the three cases suggest that CPAP may prolong the time of blood pressure rise among twin pregnancies where chronic hypertension and OSAHS coexist, which potentially reduces the occurrence of adverse maternal and infant outcomes.
