Análise das alterações anatomopatológicas macroscópicas placentárias das doenças hipertensivas específicas da gestação

• Autor(a) principal: XAVIER, Raphaela Maioni
• Data de Publicação: 2011
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• dARK ID: ark:/38995/0013000006v9k
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tde/707
• topic: Eclâmpsia; Hipertensão gestacional; Placenta; Pré-eclâmpsia; Eclâmpsia; Hipertensão gestacional;Placenta; Pré-eclâmpsia; Eclampsia; Gestational hypertension; Placenta; Pre-eclampsia; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM::ENFERMAGEM OBSTETRICA

The etiopathogenesis of gestational hypertension has been widely studied, but it is not very well established in medical literature. Due to the low uteroplacental perfusion, light to moderate hypertension in the third trimester of pregnancy may be an adaptive response of the maternal organism in order to keep adequate blood flow in the fetal compartment. This paper aims to identify the socioeconomic factors of the parturients with gestational hypertension associated with the maternal and fetal conditions, as well as the gross placental pathological changes. The study was conducted in a federal public maternity hospital in Goiânia, in the state of Goiás, between March 2009 and February 2010. Placental and clinical data of 61 parturients with and without diagnosis (control group) of gestational hypertension were collected. 18 placentas of parturients with chronic hypertension (CH) (29.5%), 11 with gestational hypertension (HGE) (18%), 3 with eclampsia (4.9%), 28 of pre-eclampsia (PE) (45.9%), and 1 diagnosed with HELLP Syndrome (1.63%). The main placental changes found were: hematomas, presence of fibrin, fibrosis, infarction, calcifilaxis and areas of detachment. There was statistically significant difference concerning the occurrence of infarction on the maternal side of women with eclampsia (p = 0.047). The deposit of fibrin on the maternal side of the placentas of women with gestational hypertension was significantly larger than that of the women in the control group (p = 0.008). Calcifilaxis was larger on the maternal side of the placentas of women in the control group when compared to the group with gestational hypertension (p = 0.056). A statistically significant result was obtained when analyzing the presence of fibrin in the groups of PE and control (p = 0.024). There was a significantly larger deposit of fibrin on the fetal side of the placentas of women with HGE than of those in the control group (p = 0.048). Hypertensive disorders of pregnancy are studied as a worldwide problem of public health and rank third among the causes of maternal death in the world and first in Brazil. This is the reason why this study was carried out taking into consideration the need of an increasingly humanized obstetric care focused on the main placental changes and their impact on maternal and fetal vitality in the puerperium.