Pankiewicz Katarzyna, Szczerba Ewa, Maciejewski Tomasz, Fijałkowska Anna
Department of Obstetrics and Gynaecology, Institute of Mother and Child, Warsaw, Poland.
Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.
Prz Menopauzalny. 2019 Jun;18(2):99-109. doi: 10.5114/pm.2019.85785. Epub 2019 Jun 14.
Preeclampsia is a multisystem disorder of pregnancy that remains a leading cause of maternal and foetal morbidity and mortality. It is still an underestimated risk factor for future cardiovascular, cerebrovascular, and kidney disease, developing often in the perimenopausal period of a woman's life. It remains unclear whether preeclampsia is an individual risk factor for future cardiovascular, cerebrovascular, and renal events or an early marker of women with high-risk profiles for these diseases. Risk factors for cardiovascular disorders and preeclampsia are very similar and include the following: obesity, dyslipidaemia, insulin resistance, pro-inflammatory and hypercoagulable state, and endothelial dysfunction. Thus, the pregnancy can only be a trigger for cardiovascular alterations that manifest in development of preeclampsia. On the other hand, there is strong evidence that changes in cardiovascular, endothelial, and metabolic systems occurring in the course of preeclampsia may not fully recover after delivery and can be a cause of future disease, especially in the presence of other metabolic risk factors regarding, for example, perimenopause. In this review the authors present current knowledge about short- and long-term maternal consequences of preeclampsia, such as: cardiovascular disease, cerebrovascular incidents (posterior reversible encephalopathy and stroke), kidney injury (including the risk of end-stage renal disease), liver failure, and coagulopathy (thrombocytopenia and disseminated intravascular coagulation).
子痫前期是一种妊娠多系统疾病,仍然是孕产妇和胎儿发病及死亡的主要原因。它仍是未来心血管、脑血管和肾脏疾病的一个被低估的危险因素,常在女性围绝经期发病。子痫前期究竟是未来心血管、脑血管和肾脏事件的个体危险因素,还是这些疾病高危女性的早期标志物,目前尚不清楚。心血管疾病和子痫前期的危险因素非常相似,包括:肥胖、血脂异常、胰岛素抵抗、促炎和高凝状态以及内皮功能障碍。因此,妊娠可能只是子痫前期发展过程中心血管改变的一个触发因素。另一方面,有强有力的证据表明,子痫前期过程中发生的心血管、内皮和代谢系统变化在产后可能无法完全恢复,并且可能是未来疾病的一个原因,尤其是在存在其他代谢危险因素(例如围绝经期)的情况下。在这篇综述中,作者介绍了有关子痫前期对母亲短期和长期影响的当前知识,例如:心血管疾病、脑血管事件(后部可逆性脑病和中风)、肾损伤(包括终末期肾病风险)、肝衰竭和凝血病(血小板减少症和弥散性血管内凝血)。