Pre-eclampsia/Eclampsia

José Carlos Peraçoli; Vera Therezinha Medeiros Borges; José Geraldo Lopes Ramos; Ricardo de Carvalho Cavalli; Sérgio Hofmeister de Almeida Martins Costa; Leandro Gustavo de Oliveira; Francisco Lazaro Pereira de Souza; Henri Augusto Korkes; Ione Rodrigues Brum; Maria Laura Costa; Mário Dias Corrêa Junior; Nelson Sass; Angélica Lemos Debs Diniz; Caio Antonio de Campos Prado; Edson Viera da Cunha Filho

doi:10.1055/s-0039-1687859

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, Inhaltsverzeichnis

CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(05): 318-332
DOI: 10.1055/s-0039-1687859

Febrasgo Statement

Thieme Publicações Ltda Rio de Janeiro, Brazil

Pre-eclampsia/Eclampsia

Pré-eclâmpsia/Eclâmpsia

Autor*innen

José Carlos Peraçoli

¹Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
Vera Therezinha Medeiros Borges

¹Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
José Geraldo Lopes Ramos

²Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
Ricardo de Carvalho Cavalli

³Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
Sérgio Hofmeister de Almeida Martins Costa

²Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
Leandro Gustavo de Oliveira

¹Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
Francisco Lazaro Pereira de Souza

⁴Department of Tocoginecology, Centro Universitário Lusíada, Santos, SP, Brazil
Henri Augusto Korkes

⁵Department of Obstetrics and Gynecology, Faculty of Medicine, Pontifícia Universidade Católica de São Paulo, São Paulo, SP, Brazil
Ione Rodrigues Brum

⁶Department of Maternal and Child Health, Faculty of Medicine, Universidade Federal do Amazonas, Manaus, AM, Brazil
Maria Laura Costa

⁷Department of Gynecology and Obstetrics, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
Mário Dias Corrêa Junior

⁸Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
Nelson Sass

⁹Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil
Angélica Lemos Debs Diniz

¹⁰Department of Obstetrics and Gynecology, Faculty of Medicine, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
Caio Antonio de Campos Prado

³Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
Edson Viera da Cunha Filho

¹¹Gynecology and Obstetrics Training Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil

Abstract

Pre-eclampsia is a multifactorial and multisystemic disease specific to gestation. It is classically diagnosed by the presence of hypertension associated with proteinuria manifested in a previously normotensive pregnant woman after the 20^th week of gestation. Pre-eclampsia is also considered in the absence of proteinuria if there is target organ damage. The present review takes a general approach focused on aspects of practical interest in the clinical and obstetric care of these women. Thus, it explores the still unknown etiology, current aspects of pathophysiology and of the diagnosis, the approach to disease prediction, its adverse outcomes and prevention. Management is based on general principles, on nonpharmacological and on pharmacological clinical treatment of severe or nonsevere situations with emphasis on the hypertensive crisis and eclampsia. Obstetric management is based on preeclampsia without or with signs of clinical and/or laboratory deterioration, stratification of gestational age in < 24 weeks, between 24 and less than 34 weeks, and ≥ 34 weeks of gestation, and guidance on route of delivery. An immediate puerperium approach and repercussions in the future life of pregnant women who develop preeclampsia is also presented.

Resumo

A pré-eclâmpsia é uma doença multifatorial e multissistêmica específica da gestação. É classicamente diagnosticada pela presença de hipertensão arterial associada à proteinúria em gestante previamente normotensa após a 20^a semana de gestação. A pré-eclâmpsia também é considerada na ausência de proteinúria se houver lesão de órgão-alvo. A presente revisão tem uma abordagem geral focada em aspectos de interesse prático na assistência clínica e obstétrica dessas mulheres. Assim, explora a etiologia ainda desconhecida, aspectos atuais da fisiopatologia e do diagnóstico e diagnóstico diferencial de convulsões, a abordagem da predição da doença, seus resultados adversos e prevenção. A conduta baseia-se em princípios gerais, tratamento clínico não farmacológico e farmacológico de situações graves ou não graves, com ênfase na crise hipertensiva e eclâmpsia. O controle obstétrico se fundamenta na pré-eclâmpsia sem ou com sinais de deterioração clínica e/ou laboratorial, estratificação da idade gestacional abaixo de 24 semanas, entre 24 e menos de 34 semanas e 34 ou mais semanas de gestação e orientação na via de parto. Uma abordagem imediata do puerpério e repercussões na vida futura de gestantes que desenvolvem pré-eclâmpsia também foram apresentadas.

Keywords

gestation - hypertensive disorders - pre-eclampsia - eclampsia

Palavras-chave

gestação - distúrbios hipertensivos - hipertensão arterial - pré-eclâmpsia - eclâmpsia

Volltext

Referenzen

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