Pre-eclampsia.

Autor: Dimitriadis E; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.; Gynaecology Research Centre, Royal Women's Hospital, Melbourne, Victoria, Australia., Rolnik DL; Women's and Newborn, Monash Health, Melbourne, Victoria, Australia.; Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia., Zhou W; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.; Gynaecology Research Centre, Royal Women's Hospital, Melbourne, Victoria, Australia., Estrada-Gutierrez G; Research Division, Instituto Nacional de Perinatologia, Mexico City, Mexico., Koga K; Department of Obstetrics and Gynecology, University of Tokyo, Tokyo, Japan.; Department of Reproductive Medicine, Chiba University, Chiba, Japan., Francisco RPV; Departamento de Obstetrícia e Giencologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., Whitehead C; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.; Fetal Medicine Unit, Royal Women's Hospital, Melbourne, Victoria, Australia., Hyett J; Obstetric Research Group Ingham Institute, South Western Sydney Local Health District and Western Sydney University, Sydney, New South Wales, Australia., da Silva Costa F; Maternal Fetal Medicine Unit, Gold Coast University Hospital and School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia., Nicolaides K; Fetal Medicine Foundation, London, UK.; Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK., Menkhorst E; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia. ellen.menkhorst@unimelb.edu.au.; Gynaecology Research Centre, Royal Women's Hospital, Melbourne, Victoria, Australia. ellen.menkhorst@unimelb.edu.au.
Jazyk: angličtina
Zdroj: Nature reviews. Disease primers [Nat Rev Dis Primers] 2023 Feb 16; Vol. 9 (1), pp. 8. Date of Electronic Publication: 2023 Feb 16.
DOI: 10.1038/s41572-023-00417-6
Abstrakt: Pre-eclampsia is a life-threatening disease of pregnancy unique to humans and a leading cause of maternal and neonatal morbidity and mortality. Women who survive pre-eclampsia have reduced life expectancy, with increased risks of stroke, cardiovascular disease and diabetes, while babies from a pre-eclamptic pregnancy have increased risks of preterm birth, perinatal death and neurodevelopmental disability and cardiovascular and metabolic disease later in life. Pre-eclampsia is a complex multisystem disease, diagnosed by sudden-onset hypertension (>20 weeks of gestation) and at least one other associated complication, including proteinuria, maternal organ dysfunction or uteroplacental dysfunction. Pre-eclampsia is found only when a placenta is or was recently present and is classified as preterm (delivery <37 weeks of gestation), term (delivery ≥37 weeks of gestation) and postpartum pre-eclampsia. The maternal syndrome of pre-eclampsia is driven by a dysfunctional placenta, which releases factors into maternal blood causing systemic inflammation and widespread maternal endothelial dysfunction. Available treatments target maternal hypertension and seizures, but the only 'cure' for pre-eclampsia is delivery of the dysfunctional placenta and baby, often prematurely. Despite decades of research, the aetiology of pre-eclampsia, particularly of term and postpartum pre-eclampsia, remains poorly defined. Significant advances have been made in the prediction and prevention of preterm pre-eclampsia, which is predicted in early pregnancy through combined screening and is prevented with daily low-dose aspirin, starting before 16 weeks of gestation. By contrast, the prediction of term and postpartum pre-eclampsia is limited and there are no preventive treatments. Future research must investigate the pathogenesis of pre-eclampsia, in particular of term and postpartum pre-eclampsia, and evaluate new prognostic tests and treatments in adequately powered clinical trials.
(© 2023. Springer Nature Limited.)
Databáze: MEDLINE
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