Preeclampsia: Acute Complications and Management Priorities

Witcher, Patricia M.

doi:10.4037/aacnacc2018710

Cited by 30 publications

(25 citation statements)

References 63 publications

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“…Leptin, another adipokine that is increased in obesity, induces activation of the NADPH oxidase, which impairs endothelium-dependent vasodilatation by increasing NO degradation (Fortuño et al, 2010). All this leads to a NO deficit which affects endothelial integrity and functioning, that by itself it is deleterious, but in association to pregnancy, where the endothelial function plays a fundamental role in the adequate remodeling of the uterine arteries, and in the hemodynamic adaptations, becomes determinant in the development of preeclampsia-eclampsia, diseases with a high rate of maternal and fetal morbidity and mortality (Witcher, 2018).…”

Section: The Mechanisms Linking Obesity and Preeclampsiamentioning

confidence: 99%

Obesity and Preeclampsia: Common Pathophysiological Mechanisms

et al. 2018

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Preeclampsia is a disorder specific of the human being that appears after 20 weeks of pregnancy, characterized by new onset of hypertension and proteinuria. Abnormal placentation and reduced placental perfusion associated to impaired trophoblast invasion and alteration in the compliance of uterine spiral arteries are the early pathological findings that are present before the clinical manifestations of preeclampsia. Later on, the endothelial and vascular dysfunction responsible of the characteristic vasoconstriction of preeclampsia appear. Different nutritional risk factors such as a maternal deficit in the intake of calcium, protein, vitamins and essential fatty acids, have been shown to play a role in the genesis of preeclampsia, but also an excess of weight gain during pregnancy or a pre-pregnancy state of obesity and overweight, which are associated to hyperinsulinism, insulin resistance and maternal systemic inflammation, are proposed as one of the mechanism that conduce to endothelial dysfunction, hypertension, proteinuria, thrombotic responses, multi-organ damage, and high maternal mortality and morbidity. Moreover, it has been demonstrated that pregnant women that suffer preeclampsia will have an increased risk of future cardiovascular disease and related mortality in their later life. In this article we will discuss the results of studies performed in different populations that have shown an interrelationship between obesity and overweight with the presence of preeclampsia. Moreover, we will review some of the common mechanisms that explain this interrelationship, particularly the alterations in the L-arginine/nitric oxide pathway as a crucial mechanism that is common to obesity, preeclampsia and cardiovascular diseases.

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Section: The Mechanisms Linking Obesity and Preeclampsiamentioning

confidence: 99%

Obesity and Preeclampsia: Common Pathophysiological Mechanisms

et al. 2018

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“…Hypertensive disorders complicating pregnancy are dangerous complication, which affect 2–10% of all pregnancies worldwide 1 . Pre‐eclampsia (PE) is defined as new onset hypertension and proteinuria, which occurs after 20 weeks of gestation combined with other maternal organ dysfunction, such as liver or renal insufficiency, hematological or neurological complications, uteroplacental dysfunction and fetal growth restriction 2 .…”

Section: Introductionmentioning

confidence: 99%

Serum fibroblast growth factor 21 level is increased in pre‐eclampsia patients: Association with blood pressure and lipid profile

Lin

Zhou

Huang

2020

J of Obstet and Gynaecol

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BackgroundPre‐eclampsia (PE) is dangerous complication, which leads to adverse pregnancy outcomes.AimsThe study was to explore the correlation between serum level of fibroblast growth factor (FGF) 21 and PE.MethodsA total of 80 cases were involved in this study containing PE group (49 cases) and control group (31 cases, normal pregnancy). PE group was divided into early‐onset PE (EOPE) and late‐onset PE (LOPE). Serum level of FGF21 and biochemical parameters were measured before delivery.ResultsMaternal serum FGF21 level was higher in PE especially in EOPE than that in control groups (P < 0.05). In PE patients, serum FGF21 level was positively correlated with mean arterial pressure, diastolic blood pressure and low‐density lipoprotein cholesterol (P < 0.05). Levels of FGF21, uric acid and low‐density lipoprotein cholesterol were risk factors for PE.ConclusionMaternal serum FGF21 level in PE particularly in EOPE was higher and was associated with blood pressure and lipid profile.

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“…Симптомы и симптомокомплексы, появление которых указывает на развитие критической ситуации [13,14]: боль в груди; одышка; отек легких; тромбоцитопения; повышение уровня аланинаминотрансферазы, аспартаминотрансферазы, лактатдегидрогеназы, развитие HELLP-синдрома; уровень креатинина > 90 мкмоль/л, диастолическое АД > 110 мм рт. ст.…”

Section: клинически значимая протеинурияunclassified

Preeclampsia. Eclampsia. Anesthesia and intensive care in childbirth and the puerperium. Review

Pylaeva¹,

Shifman²,

Куликов³

et al. 2020

Annals of Critical Care

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The review discusses the possibilities of predicting preeclampsia and its complications, modern criteria for the diagnosis of gestational hypertensive disorders and tactics of their intensive therapy. Particular attention was devoted on the anesthetic management for cesarean section in a woman with preeclampsia and its complications. The information proposed in the review makes it possible to define a unified terminology and form unified evidence-based interdisciplinary approaches to the diagnosis and treatment of preeclampsia, which will improve maternal and fetal outcome.

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Preeclampsia: Acute Complications and Management Priorities

Cited by 30 publications

References 63 publications

Obesity and Preeclampsia: Common Pathophysiological Mechanisms

Obesity and Preeclampsia: Common Pathophysiological Mechanisms

Serum fibroblast growth factor 21 level is increased in pre‐eclampsia patients: Association with blood pressure and lipid profile

Preeclampsia. Eclampsia. Anesthesia and intensive care in childbirth and the puerperium. Review

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