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子痫前期:疾病生物学与负担,以及印度的管理策略

Preeclampsia: Disease biology and burden, its management strategies with reference to India.

作者信息

Malik Ankita, Jee Babban, Gupta Satish Kumar

机构信息

Reproductive Cell Biology Lab, National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi 110 067, India.

Department of Health Research, Ministry of Health and Family Welfare, Government of India, New Delhi 110 001, India.

出版信息

Pregnancy Hypertens. 2019 Jan;15:23-31. doi: 10.1016/j.preghy.2018.10.011. Epub 2018 Nov 2.

Abstract

Preeclampsia is the cause of significant maternal and fetal mortality and morbidity. It is characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. Preeclamptic women and children born from preeclamptic pregnancies are at greater risk to develop severe cardiovascular complications and metabolic syndromes later in life. The incidence of preeclampsia is estimated to be seven times higher in developing countries as compared to the developed countries. This review summarizes the pathophysiology of preeclampsia, emerging new hypothesis of its origin, risk factors that make women susceptible to developing preeclampsia and the potential of various biomarkers being studied to predict preeclampsia. The health care of developing countries is continuously challenged by substantial burden of maternal and fetal mortality. India despite being a fast developing country, is still far behind in achieving the required maternal mortality rates as per Millennium Development Goals set by the World Health Organization. Further, this review discusses the prevalence of preeclampsia in India, health facilities to manage preeclampsia, current guidelines and protocols followed and government policies to combat this complication in Indian condition.

摘要

子痫前期是导致孕产妇和胎儿显著死亡及发病的原因。其特征为妊娠20周后新发高血压和蛋白尿。子痫前期孕妇以及子痫前期妊娠所分娩的儿童在生命后期发生严重心血管并发症和代谢综合征的风险更高。据估计,发展中国家子痫前期的发病率比发达国家高7倍。本综述总结了子痫前期的病理生理学、其起源的新假说、使女性易患子痫前期的危险因素以及正在研究的用于预测子痫前期的各种生物标志物的潜力。发展中国家的医疗保健不断受到孕产妇和胎儿死亡沉重负担的挑战。印度尽管是一个快速发展的国家,但在实现世界卫生组织设定的千年发展目标所要求的孕产妇死亡率方面仍远远落后。此外,本综述讨论了印度子痫前期的患病率、管理子痫前期的卫生设施、目前遵循的指南和方案以及印度应对这一并发症的政府政策。

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