Bohiltea Roxana Elena, Cirstoiu Monica Mihaela, Turcan Natalia, Stoian Anca Pantea, Zugravu Corina-Aurelia, Munteanu Octavian, Arsene Luciana Valentina, Oana Bodean, Neacsu Adrian, Furtunescu Florentina
Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Obstetrics and Gynecology, University Emergency Hospital Bucharest, 050098 Bucharest, Romania.
Exp Ther Med. 2021 Mar;21(3):261. doi: 10.3892/etm.2021.9691. Epub 2021 Jan 25.
Methods to prevent the development of pathologies due to placental dysfunctions, such as gestational hypertension and preeclampsia, are the main approaches for obtaining the best maternal and fetal antepartum and postpartum prognosis. During 5 years of study (January, 2015 to December, 2019), the cases of pregnancy and puerperium complicated with pathology due to placental dysfunction were analyzed. The main objective was to determine the magnitude of the impact of thrombophilia on the development of an entity of gestational hypertension disorder. We compared the impact of thrombophilia and its associated complications in patients with gestational hypertension with moderate and severe preeclampsia. Thus, we found obesity, thrombophilia, and underlying cardiac pathology to be significant risk factors for severe preeclampsia. Regarding the comparative analysis of the risk factors and complications associated with patients with mild preeclampsia compared with those with severe preeclampsia, the presence in severe preeclampsia of thrombophilia, endocrine, liver, and cardiac pathology was higher and, a higher rate of complications was observed; complications included fetal death, intrauterine growth restriction (IUGR), prematurity, fetal arrhythmia with acute fetal distress, HELLP syndrome, and placental abruption. Thrombophilia has a significant effect on the development of severe preeclampsia, and oligohydramnios as specific complication of mild preeclampsia. Factors indicating an increased risk of progression from mild preeclampsia to severe preeclampsia are in addition to inherited thrombophilia the underlying pathologies, namely cardiac, hepatic, and endocrine factors.
预防因胎盘功能障碍导致的病理状况（如妊娠期高血压和子痫前期）的方法，是获得最佳母婴产前和产后预后的主要途径。在5年的研究期间（2015年1月至2019年12月），对妊娠和产褥期合并胎盘功能障碍所致病理状况的病例进行了分析。主要目的是确定血栓形成倾向对妊娠期高血压疾病实体发展的影响程度。我们比较了血栓形成倾向及其相关并发症在中度和重度子痫前期妊娠期高血压患者中的影响。因此，我们发现肥胖、血栓形成倾向和潜在的心脏病理状况是重度子痫前期的重要危险因素。关于轻度子痫前期患者与重度子痫前期患者相关危险因素和并发症的比较分析，重度子痫前期患者中血栓形成倾向、内分泌、肝脏和心脏病理状况的发生率更高，且观察到更高的并发症发生率；并发症包括胎儿死亡、宫内生长受限（IUGR）、早产、伴有急性胎儿窘迫的胎儿心律失常、HELLP综合征和胎盘早剥。血栓形成倾向对重度子痫前期的发展有显著影响，对轻度子痫前期的特异性并发症羊水过少也有显著影响。除了遗传性血栓形成倾向外，潜在的病理状况，即心脏、肝脏和内分泌因素，也是提示轻度子痫前期进展为重度子痫前期风险增加的因素。
