期刊
CURRENT HYPERTENSION REPORTS
卷 16, 期 8, 页码 -出版社
SPRINGER
DOI: 10.1007/s11906-014-0454-8
关键词
Pre-eclampsia; Pregnancy hypertension; Classification; Pathogenesis; Risk factors; Prediction; Angiogenic factors; Metabolomics; Proteomics; Prevention; Heparin; Aspirin; Calcium; Diagnosis; Risk stratification; Outcome prediction; Timing of delivery; Antihypertensive management; Magnesiumsulfate; Eclampsia; Fetal neuroprotection; Long-termoutcomes
资金
- Child and Family Research Institute
- University of British Columbia
- BC Women's Hospital and Health Centre
- fullPIERS project
Pre-eclampsia remains the second leading direct cause of maternal death, > 99 % of which occurs in less developed countries. Over 90 percent of the observed reduction in pre-eclampsia-related maternal deaths in the UK (1952-2008) occurred with antenatal surveillance and timed delivery. In this review, we discuss the pathogenesis, diagnostic criteria, disease prediction models, prevention and management of pre-eclampsia. The Pre-eclampsia Integrated Estimate of RiSk (PIERS) models and markers of angiogenic imbalance identify women at incremental risk for severe pre-eclampsia complications. For women at high risk of developing pre-eclampsia, low doses of aspirin (especially if started < 17 weeks) and calcium are evidence-based preventative strategies; heparin is less so. Severe hypertension must be treated and the Control of Hypertension In Pregnancy (CHIPS) Trial (reporting: 2014) will guide non-severe hypertension management. Magnesium sulfate prevents and treats eclampsia; there is insufficient evidence to support alternative regimens. Pre-eclampsia predicts later cardiovascular disease; however, at this time we do not know what to do about it.
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