Vigil-De Gracia Paulino, Vargas Carlos, Sánchez Joanne, Collantes-Cubas Jorge
Hospital Complex of the Social Security Fund Hospital Doctor Arnulfo Arias Madrid (Complejo Hospitalario de la Caja de Seguro Social); Distinguished Researcher at the National System of Researchers, SENACYT, Panama, Panama.
Ginecología y Obstetricia, Hospital Complex of the Social Security Fund Hospital Doctor Arnulfo Arias Madrid (Complejo Hospitalario de la Caja de Seguro Social), Panama, Panama.
Heliyon. 2023 Mar 1;9(3):e14187. doi: 10.1016/j.heliyon.2023.e14187. eCollection 2023 Mar.
Preeclampsia is a very complex multisystem disorder characterized by mild to severe hypertension.
PubMed and the Cochrane Library were searched from January 1, 2002 to March 31, 2022, with the search terms "pre-eclampsia" and "hypertensive disorders in pregnancy". We also look for guidelines from international societies and clinical specialty colleges and we focused on publications made after 2015.
The primary issue associated with this physiopathology is a reduction in utero-placental perfusion and ischemia. Preeclampsia has a multifactorial genesis, its focus in prevention consists of the identification of high and moderate-risk clinical factors. The clinical manifestations of preeclampsia vary from asymptomatic to fatal complications for both the fetus and the mother. In severe cases, the mother may present renal, neurological, hepatic, or vascular disease. The main prevention strategy is the use of aspirin at low doses, started from the beginning to the end of the second trimester and maintained until the end of pregnancy.
Preeclampsia is a multisystem disorder; we do not know how to predict it accurately. Acetylsalicylic acid at low doses to prevent a low percentage, especially in patients with far from term preeclampsia. There is evidence that exercising for at least 140 min per week reduces gestational hypertension and preeclampsia. Currently, the safest approach is the termination of pregnancy. It is necessary to improve the prediction and prevention of preeclampsia, in addition, better research is needed in the long-term postpartum follow-up.
子痫前期是一种非常复杂的多系统疾病,其特征为轻至重度高血压。
检索2002年1月1日至2022年3月31日期间的PubMed和Cochrane图书馆,检索词为“子痫前期”和“妊娠期高血压疾病”。我们还查找了国际协会和临床专科院校的指南,并重点关注2015年以后发表的文献。
与这种病理生理学相关的主要问题是子宫胎盘灌注减少和缺血。子痫前期有多种病因,其预防重点在于识别高风险和中度风险的临床因素。子痫前期的临床表现从无症状到对胎儿和母亲的致命并发症不等。在严重病例中,母亲可能出现肾脏、神经、肝脏或血管疾病。主要的预防策略是从孕中期开始至结束全程使用低剂量阿司匹林,并持续至妊娠结束。
子痫前期是一种多系统疾病;我们尚不知如何准确预测它。低剂量乙酰水杨酸预防效果欠佳,尤其是对于孕周较小的子痫前期患者。有证据表明,每周至少锻炼140分钟可降低妊娠期高血压和子痫前期的发生风险。目前,最安全的方法是终止妊娠。有必要改善子痫前期的预测和预防,此外,还需要对产后长期随访进行更好的研究。