Bhojwani Kashish, Agrawal Anil
Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Oct 16;14(10):e30347. doi: 10.7759/cureus.30347. eCollection 2022 Oct.
Pregnancy disorders include, most commonly, hypertensive disorders, which include gestational hypertension, preeclampsia, and chronic hypertension with superimposed preeclampsia. Various etiological factors prove to be both risks as well as protective factors, which include genetic factors, maternal smoking (it is inversely related to preeclampsia; that is, smoking decreases the incidence of preeclampsia), and other medical comorbidities such as hypertension, diabetes, asthma, and others, including older maternal age and high body mass index. Usually, high maternal and fetal mortality rates are seen with the diagnosis of hypertensive disorders in pregnancy, and severe morbidity is seen in cases of preeclampsia, eclampsia, and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), along with raised levels of liver enzymes and blood disorders such as low platelet counts. Preeclampsia is considered one of the most serious consequences of pregnancy. These disorders are often presented as newly diagnosed high blood pressure and proteinuria during the last trimester. But it can prove to be fatal for both the mother and the fetus. Though the causative factors of preeclampsia are still unknown, specific clinical and histopathological researchers propose that preeclampsia can be due to pathological changes in the placenta. The basic aim of this article is to discuss various histopathological changes in the placenta due to preeclampsia, but minor topics that affect the pathophysiology of the placenta due to preeclampsia are also mentioned. Furthermore, the effective management of maternal syndrome complications in pregnancy has also been discussed.
妊娠疾病最常见的包括高血压疾病,其中有妊娠期高血压、子痫前期以及慢性高血压并发子痫前期。各种病因因素既是风险因素也是保护因素,包括遗传因素、孕妇吸烟(与子痫前期呈负相关,即吸烟会降低子痫前期的发病率),以及其他合并症,如高血压、糖尿病、哮喘等,还包括孕妇年龄较大和体重指数较高。通常,妊娠高血压疾病诊断时会出现较高的孕产妇和胎儿死亡率,子痫前期、子痫和HELLP综合征(溶血、肝酶升高和血小板计数降低)病例会出现严重并发症,同时伴有肝酶水平升高和血液系统疾病,如血小板计数降低。子痫前期被认为是妊娠最严重的后果之一。这些疾病通常表现为妊娠晚期新诊断出的高血压和蛋白尿。但它对母亲和胎儿都可能是致命的。尽管子痫前期的病因仍不清楚,但具体的临床和组织病理学研究表明,子痫前期可能是由于胎盘的病理变化所致。本文的基本目的是讨论子痫前期导致的胎盘各种组织病理学变化,但也提及了子痫前期影响胎盘病理生理学的一些次要话题。此外,还讨论了妊娠期孕产妇综合征并发症的有效管理。