Bohiltea Roxana Elena, Zugravu Corina-Aurelia, Nemescu Dragos, Turcan Natalia, Paulet Florina-Paula, Gherghiceanu Florentina, Ducu Ionita, Cirstoiu Monica Mihaela
Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania.
Department of Food Hygiene and Nutrition, 'Carol Davila' University of Medicine and Pharmacy, 050463 Bucharest, Romania.
Exp Ther Med. 2020 Sep;20(3):2423-2428. doi: 10.3892/etm.2020.8783. Epub 2020 May 21.
The prevalence of pathologies due to placental dysfunction superimposed on pregnancy is constantly increasing. The prognosis of the cases complicated by gestational hypertension is usually good, significantly better compared with that of the cases associating preeclampsia. About half of the cases with gestational hypertension will progress to preeclampsia, the risk of decompensation being inversely proportional to the gestational age of the onset of gestational hypertension. The present study, analyzed the cases of pregnancy and postpartum complicated by pathologies related to placental dysfunction, during a period of 5 years. The risk factors analyzed were the presence of infections during pregnancy, diabetes, thrombophilia, pregnancy obtained by fertilization, abnormal adherence of the placenta, obesity, multiple pregnancy, the presence of an earlier hepatic, endocrine, renal, cardiac or autoimmune pathology, and the existence of an uterine malformation. Obesity appears with a significantly increased incidence in patients with gestational hypertension and middle preeclampsia. Intrauterine growth restriction appears with a significantly increased incidence in patients with mild preeclampsia. Complications such as prematurity, acute fetal distress and abruption of placentae had a significantly increased incidence in patients with severe preeclampsia. Thus, obese patients have a higher risk of moderate preeclampsia, following gestational hypertension and finally severe preeclampsia.
妊娠合并胎盘功能障碍所致疾病的患病率在持续上升。妊娠期高血压并发症患者的预后通常良好，与子痫前期相关病例相比明显更好。约一半的妊娠期高血压病例会进展为子痫前期，失代偿风险与妊娠期高血压发病时的孕周成反比。本研究分析了5年间妊娠和产后合并胎盘功能障碍相关疾病的病例。分析的危险因素包括孕期感染、糖尿病、血栓形成倾向、体外受精妊娠、胎盘异常粘连、肥胖、多胎妊娠、既往存在肝脏、内分泌、肾脏、心脏或自身免疫性疾病以及子宫畸形。肥胖在妊娠期高血压和中度子痫前期患者中的发病率显著增加。轻度子痫前期患者中，胎儿生长受限的发病率显著增加。早产、急性胎儿窘迫和胎盘早剥等并发症在重度子痫前期患者中的发病率显著增加。因此，肥胖患者发生中度子痫前期、继之妊娠期高血压以及最终重度子痫前期的风险更高。
