Diagnosis, pathophysiology and management of pre-eclampsia: a review

Detalhes bibliográficos
Autor(a) principal: Machado,Susana
Data de Publicação: 2013
Outros Autores: Neves,Marta, Freitas,Luis, Campos,Mario
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692013000300004
Resumo: Pre-eclampsia is a multisystem disease that occurs in 2 to 8% of pregnant women and is a leading cause of maternal and perinatal morbidity and mortality. It is classically defined by new -onset hypertension and proteinuria after 20 weeks of gestation. In recent years, we have witnessed a substantial advance in the understanding of the pathogenesis of this condition. All disease subtypes are characterized by a disruption of vascular remodelling and a systemic antiangiogenic response that leads to hypertension, proteinuria, glomerular endotheliosis, HELLP (haemolysis, elevated liver enzymes, and low platelets) syndrome, and cerebral oedema-the clinical signs of pre -eclampsia and eclampsia. In the clinical practice, there is currently no reliable screening method in the first trimester of pregnancy with sufficient accuracy to identify women at high risk of developing pre-eclampsia, and only two interventions are strongly recommended by the World Health Organization for prevention of pre-eclampsia: calcium supplementation in all women with low dietary calcium intake and low -dose aspirin. Delivery is the only known cure. The treatment of pre-eclampsia and its complications is usually carried out by obstetricians but the role of nephrologists can be crucial, particularly when the condition is complicated by acute kidney injury. Several recent studies have shown an association between early -onset or severe pre -eclampsia and an increased risk of cardiovascular and/or renal disease later in life, suggesting that these women deserve a more careful monitoring programme, including clinical evaluation by nephrologists
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spelling Diagnosis, pathophysiology and management of pre-eclampsia: a reviewDiagnosispre-eclampsiapregnancypreventiontreatmentvascular endothelial growth factorPre-eclampsia is a multisystem disease that occurs in 2 to 8% of pregnant women and is a leading cause of maternal and perinatal morbidity and mortality. It is classically defined by new -onset hypertension and proteinuria after 20 weeks of gestation. In recent years, we have witnessed a substantial advance in the understanding of the pathogenesis of this condition. All disease subtypes are characterized by a disruption of vascular remodelling and a systemic antiangiogenic response that leads to hypertension, proteinuria, glomerular endotheliosis, HELLP (haemolysis, elevated liver enzymes, and low platelets) syndrome, and cerebral oedema-the clinical signs of pre -eclampsia and eclampsia. In the clinical practice, there is currently no reliable screening method in the first trimester of pregnancy with sufficient accuracy to identify women at high risk of developing pre-eclampsia, and only two interventions are strongly recommended by the World Health Organization for prevention of pre-eclampsia: calcium supplementation in all women with low dietary calcium intake and low -dose aspirin. Delivery is the only known cure. The treatment of pre-eclampsia and its complications is usually carried out by obstetricians but the role of nephrologists can be crucial, particularly when the condition is complicated by acute kidney injury. Several recent studies have shown an association between early -onset or severe pre -eclampsia and an increased risk of cardiovascular and/or renal disease later in life, suggesting that these women deserve a more careful monitoring programme, including clinical evaluation by nephrologistsSociedade Portuguesa de Nefrologia2013-09-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692013000300004Portuguese Journal of Nephrology & Hypertension v.27 n.3 2013reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692013000300004Machado,SusanaNeves,MartaFreitas,LuisCampos,Marioinfo:eu-repo/semantics/openAccess2024-02-06T17:04:42Zoai:scielo:S0872-01692013000300004Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:18:50.767025Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Diagnosis, pathophysiology and management of pre-eclampsia: a review
title Diagnosis, pathophysiology and management of pre-eclampsia: a review
spellingShingle Diagnosis, pathophysiology and management of pre-eclampsia: a review
Machado,Susana
Diagnosis
pre-eclampsia
pregnancy
prevention
treatment
vascular endothelial growth factor
title_short Diagnosis, pathophysiology and management of pre-eclampsia: a review
title_full Diagnosis, pathophysiology and management of pre-eclampsia: a review
title_fullStr Diagnosis, pathophysiology and management of pre-eclampsia: a review
title_full_unstemmed Diagnosis, pathophysiology and management of pre-eclampsia: a review
title_sort Diagnosis, pathophysiology and management of pre-eclampsia: a review
author Machado,Susana
author_facet Machado,Susana
Neves,Marta
Freitas,Luis
Campos,Mario
author_role author
author2 Neves,Marta
Freitas,Luis
Campos,Mario
author2_role author
author
author
dc.contributor.author.fl_str_mv Machado,Susana
Neves,Marta
Freitas,Luis
Campos,Mario
dc.subject.por.fl_str_mv Diagnosis
pre-eclampsia
pregnancy
prevention
treatment
vascular endothelial growth factor
topic Diagnosis
pre-eclampsia
pregnancy
prevention
treatment
vascular endothelial growth factor
description Pre-eclampsia is a multisystem disease that occurs in 2 to 8% of pregnant women and is a leading cause of maternal and perinatal morbidity and mortality. It is classically defined by new -onset hypertension and proteinuria after 20 weeks of gestation. In recent years, we have witnessed a substantial advance in the understanding of the pathogenesis of this condition. All disease subtypes are characterized by a disruption of vascular remodelling and a systemic antiangiogenic response that leads to hypertension, proteinuria, glomerular endotheliosis, HELLP (haemolysis, elevated liver enzymes, and low platelets) syndrome, and cerebral oedema-the clinical signs of pre -eclampsia and eclampsia. In the clinical practice, there is currently no reliable screening method in the first trimester of pregnancy with sufficient accuracy to identify women at high risk of developing pre-eclampsia, and only two interventions are strongly recommended by the World Health Organization for prevention of pre-eclampsia: calcium supplementation in all women with low dietary calcium intake and low -dose aspirin. Delivery is the only known cure. The treatment of pre-eclampsia and its complications is usually carried out by obstetricians but the role of nephrologists can be crucial, particularly when the condition is complicated by acute kidney injury. Several recent studies have shown an association between early -onset or severe pre -eclampsia and an increased risk of cardiovascular and/or renal disease later in life, suggesting that these women deserve a more careful monitoring programme, including clinical evaluation by nephrologists
publishDate 2013
dc.date.none.fl_str_mv 2013-09-01
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dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.source.none.fl_str_mv Portuguese Journal of Nephrology & Hypertension v.27 n.3 2013
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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