Preeclampsia / eclampsia:challenge for obstetrician-Gynecologist

The uterus to placenta blood flow reduction would be the initial factor for preeclampsia, secondary to anomalous spiral uterine arteries invasion by the extravillous cytotrophoblastic cells, associated to both vascular tonus and immunologic and inflammatory balance local alterations, sometimes with...

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Bibliographic Details
Author: Pacheco, José
Format: article
Status:Published version
Publication Date:2006
Country:Perú
Institution:Colegio Médico del Perú
Repository:Acta Médica Peruana
Language:Spanish
OAI Identifier:oai:amp.cmp.org.pe:article/1160
Online Access:https://amp.cmp.org.pe/index.php/AMP/article/view/1160
Access Level:Open access
Keyword:Hipertensión arterial
Embarazo
Preeclampsia
Eclampsia
Tono vascular
Hypertension
Pregnancy
Vascular tone
Description
Summary:The uterus to placenta blood flow reduction would be the initial factor for preeclampsia, secondary to anomalous spiral uterine arteries invasion by the extravillous cytotrophoblastic cells, associated to both vascular tonus and immunologic and inflammatory balance local alterations, sometimes with genetic predisposition. There is endothelial cell dysfunction, dyslipidemia (especially hypertriglyceridemia), hyperinsulinemia, hyperleptinemia, antioxidant-prooxidant imbalance. Preeclampsia is an early pregnancy disease characterized by hypertension and proteinuria, expressed late in pregnancy. We still do not have a clinical useful test to predict preeclampsia. Combining both placental insufficiency and endothelial markers and PlGF y sFlT-1 serum or urinary levels in the first trimester is promising. Personal and familiar hypertension history is extremely important. Pregnant women with arterial hypertension should be attended in specialized centers. The antihypertensive therapy has little effect on pregnancy outcome. We suggest the use of low doses of aspirin in women with previous early preeclampsia. Calcium channel blockers are very useful in treating acute hypertension. Preeclampsia treatment consists in the birth of both fetus and placenta, the time determined by maternal and fetal conditions.