Hypertensive Disorders of Pregnancy

Abstract

Preeclampsia is a hypertensive disorder of pregnancy that is a leading cause of maternal and perinatal morbidity and mortality. The condition presents heterogeneously at varying gestational ages. Primary prevention for preeclampsia with low-dose aspirin is recommended for patients with clinical risk factors. Despite extensive research, there is no clearly defined pathophysiology for preeclampsia or treatment for preeclampsia besides delivery of the placenta. Delivery of patients with preeclampsia without severe features is indicated in the early term period at 37 weeks’ gestation and sooner if the patient develops severe preeclampsia. Management of preterm preeclampsia is guided by close assessment of the status of the pregnant woman and fetus, blood pressure control, and surveillance for any clinical progression to a more severe form of preeclampsia that may require preterm delivery. In a preterm gestation affected by preeclampsia, expectant management is intended to provide neonatal benefit though it does assume some maternal risk. Future research will hopefully further delineate the pathophysiology of the condition with the ultimate goal of finding a treatment to avoid associated morbidity and preterm delivery.

Trastornos hipertensivos durante el embarazo

“…Vía del parto: la vía del parto dependerá del estado de gravedad de la paciente, persistencia de los síntomas de gravedad o de inminencia de eclampsia, condiciones cervicales, estado de salud fetal, presencia de RCIU, presencia de meconio, presentación fetal, existencia de estado fetal no tranquilizador, alteraciones en los exámenes de laboratorio como el deterioro de la función renal, etc. (Febres-Cordero & Young, 2021).…”

“…Por tal motivo puede valorarse la inducción del parto si no existieran complicaciones maternas y/o fetales, recordando siempre que en caso de no existir modificaciones cervicales la inducción no debe exceder las 12 horas. En casos de cesárea y existencia de un factor asociado al riesgo trombótico en el parto vaginal administrar profilaxis de la enfermedad tromboembólica con heparina de bajo peso molecular (HBPM) (Febres-Cordero & Young, 2021).…”

Evidence of Anxiety, Depression and Learning Impairments following Prenatal Hypertension

“…Hypertensive disorder of pregnancy (HDP) affects approximately 5–10% of all pregnancies [ 1 , 2 ]. Women with a history of HDPs are at an increased risk of developing mood disorders, such as anxiety and depression [ 3 , 4 , 5 ].…”