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探索子痫前期电解质失衡的范围:机制、影响及临床见解

Exploring the Spectrum of Electrolyte Imbalances in Preeclampsia: Mechanisms, Implications, and Clinical Insights.

作者信息

Gupta Aishwarya, Patel Dharmesh J, Pajai Sandhya

机构信息

Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Aug 24;16(8):e67666. doi: 10.7759/cureus.67666. eCollection 2024 Aug.

DOI:10.7759/cureus.67666
PMID:39314616
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11418792/
Abstract

Preeclampsia, a complex and perplexing disorder unique to pregnancy, is widely recognized as primarily originating from placental dysfunction and can only be resolved by the delivery of the fetus in severe cases. Preeclampsia is a prevalent medical issue during pregnancy and is associated with elevated rates of maternal and infant mortality and morbidity. The exact cause of preeclampsia remains uncertain, although multiple factors have been implicated in its development based on current knowledge. Preeclampsia is characterized by maternal endothelial dysfunction due to the presence of fetal-derived circulatory substances from the placenta. The condition is associated with various risk factors, including maternal comorbidities such as chronic renal disease, hypertension (HTN), and obesity. Additionally, a family history of preeclampsia, nulliparity, multiple gestations, previous instances of preeclampsia, or intrauterine fetal growth restriction (IUGR) are considered risk factors. Electrolytes, including sodium, potassium, and chloride, play a critical role in the function of vascular smooth muscles and may potentially contribute to the pathophysiology of hypertension. In this review, we have summarized the literature on electrolytes in preeclampsia by conducting an extensive systematic search of databases such as PubMed, Excerpta Medica database (EMBASE), and Medical Literature Analysis and Retrieval System Online (MEDLINE).

摘要

子痫前期是一种妊娠特有的复杂且令人困惑的疾病,被广泛认为主要源于胎盘功能障碍,在严重情况下只有通过分娩胎儿才能解决。子痫前期是孕期常见的医学问题,与母婴死亡率和发病率的升高有关。尽管根据目前的知识,子痫前期的发展涉及多种因素,但其确切病因仍不确定。子痫前期的特征是由于存在来自胎盘的胎儿源性循环物质导致母体血管内皮功能障碍。该疾病与多种风险因素相关,包括母体合并症,如慢性肾病、高血压(HTN)和肥胖。此外,子痫前期家族史、未生育、多胎妊娠、既往子痫前期病史或胎儿宫内生长受限(IUGR)都被视为风险因素。电解质,包括钠、钾和氯,在血管平滑肌功能中起关键作用,可能潜在地导致高血压的病理生理过程。在本综述中,我们通过对PubMed、医学文摘数据库(EMBASE)和医学文献分析与联机检索系统(MEDLINE)等数据库进行广泛的系统检索,总结了关于子痫前期中电解质的文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4e/11418792/5fc1a80133eb/cureus-0016-00000067666-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4e/11418792/293652878520/cureus-0016-00000067666-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4e/11418792/5fc1a80133eb/cureus-0016-00000067666-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4e/11418792/293652878520/cureus-0016-00000067666-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4e/11418792/5fc1a80133eb/cureus-0016-00000067666-i02.jpg

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本文引用的文献

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Pre-eclampsia.子痫前期。
Nat Rev Dis Primers. 2023 Feb 16;9(1):8. doi: 10.1038/s41572-023-00417-6.
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Therapeutic plasma exchange in HELLP syndrome: A life savior.HELLP综合征中的治疗性血浆置换:救命稻草。
Asian J Transfus Sci. 2022 Jan-Jun;16(1):106-110. doi: 10.4103/ajts.ajts_176_20. Epub 2022 May 26.
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Maternal race and pre-eclampsia: Cohort study and systematic review with meta-analysis.产妇种族与子痫前期:队列研究和系统评价及荟萃分析。
BJOG. 2022 Nov;129(12):2082-2093. doi: 10.1111/1471-0528.17240. Epub 2022 Jun 21.
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Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors.妊娠期糖尿病与子痫前期:相关性及影响因素
Front Cardiovasc Med. 2022 Feb 16;9:831297. doi: 10.3389/fcvm.2022.831297. eCollection 2022.
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Reducing health inequality in Black, Asian and other minority ethnic pregnant women: impact of first trimester combined screening for placental dysfunction on perinatal mortality.减少黑种人、亚裔及其他少数族裔孕妇的健康不平等:胎盘功能障碍的早孕期联合筛查对围产儿死亡率的影响。
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The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice.2021 年国际妊娠高血压学会分类、诊断与管理国际实践推荐建议。
Pregnancy Hypertens. 2022 Mar;27:148-169. doi: 10.1016/j.preghy.2021.09.008. Epub 2021 Oct 9.
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Chronic kidney disease and adverse pregnancy outcomes: a systematic review and meta-analysis.慢性肾脏病与不良妊娠结局:一项系统评价与荟萃分析
Am J Obstet Gynecol. 2022 May;226(5):656-670.e32. doi: 10.1016/j.ajog.2021.10.037. Epub 2021 Nov 2.
8
Fetal growth restriction as the initial finding of preeclampsia is a clinical predictor of maternal and neonatal prognoses: a single-center retrospective study.胎儿生长受限作为子痫前期的首发表现是母婴预后的临床预测指标:一项单中心回顾性研究。
BMC Pregnancy Childbirth. 2021 Oct 6;21(1):678. doi: 10.1186/s12884-021-04152-2.
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Adherence with blood pressure self-monitoring in women with pregnancy hypertension, and comparisons to clinic readings: A secondary analysis of OPTIMUM-BP.妊娠高血压女性的血压自我监测依从性及其与诊所读数的比较:OPTIMUM-BP 的二次分析。
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