Yıl: 2023 Cilt: 7 Sayı: 3 Sayfa Aralığı: 234 - 239 Metin Dili: Türkçe DOI: 10.37783/CRJ-0367 İndeks Tarihi: 27-07-2023

Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi

Öz:
Preeklampsi, gebeliğin 20. haftasından sonra hipertansiyon ve proteinüri ile birlikte veya prote-inüri olmaksızın hipertansiyon ve uç organ disfonksiyonu ile karakterize bir sendromdur. Dün-yada ve ülkemizde anne ölümlerinin kanamadan sonra ikinci en sık nedenidir. Gebeliklerin %4.6’ sında görülen, multisistemik etkileri olan preeklampsinin risk gruplarının erken tanınma-sı, multiorgan hasarının önlenebilmesi ve her hekimin klinik pratiğinde karşılaşabileceği bir hastalık olması nedeniyle bilgi sahibi olunması gereken bir hastalıktır
Anahtar Kelime:

Preeclampsia and Eclampsia (Pregnancy Toxemia): Pathogenesis, Diagnosis and Management

Öz:
Preeclampsia is a syndrome characterized by hypertension and proteinuria or hypertension and end-organ dysfunction without proteinuria after 20 weeks of pregnancy. It is the second most common cause of maternal death after bleeding in Turkey and worldwide. It is seen in 4.6% of pregnancies and has multisystemic effects. Since it is a disease that every physician may encounter in his clinical practice, it would be better to have knowledge about it in order to identify risk groups early and to prevent multiorgan damage
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Bibliyografik
  • 1. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):e237-e260.
  • 2. Magee LA, Pels A, Helewa M, et al. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can. 2014;36(5):416-41.
  • 3. Abalos E, Cuesta C, Grosso AL, et al. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):1-7.
  • 4. Keskinkılıç B, Engin-Üstün Y, Sanisoğlu S, et al. Maternal mortality due to hypertensive disorders in pregnancy, childbirth, and the puerperium between 2012 and 2015 in Turkey: A nationbased study. J Turk Ger Gynecol Assoc. 2017;18(1):20-25.
  • 5. Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019 ;145 Suppl 1(Suppl 1):1-33.
  • 6. Lain KY, Roberts JM. Contemporary concepts of the pathogenesis and management of preeclampsia. Jama. 2002;287(24):3183-6.
  • 7. Moore-Maxwell CA, Robboy SJ. Placental site trophoblastic tumor arising from antecedent molar pregnancy. Gynecol Oncol. 2004;92(2):708-12.
  • 8. Goel A, Maski MR, Bajracharya S, et al. Epidemiology and Mechanisms of De Novo and Persistent Hypertension in the Postpartum Period. Circulation. 2015;132(18):1726-33.
  • 9. Kaufmann P, Black S, Huppertz B. Endovascular trophoblast invasion: implications for the pathogenesis of intrauterine growth retardation and preeclampsia. Biol Reprod. 2003;69(1):1-7.
  • 10. Pijnenborg R, Vercruysse L, Hanssens M. The uterine spiral arteries in human pregnancy: facts and controversies. Placenta. 2006;27(9-10):939-58.
  • 11. Zhou Y, Damsky CH, Fisher SJ. Preeclampsia is associated with failure of human cytotrophoblasts to mimic a vascular adhesion phenotype. One cause of defective endovascular invasion in this syndrome? J Clin Invest. 1997;99(9):2152-64.
  • 12. Zhou Y, Damsky CH, Chiu K, et al. Preeclampsia is associated with abnormal expression of adhesion molecules by invasive cytotrophoblasts. J Clin Invest. 1993;91(3):950-60.
  • 13. Brosens I, Pijnenborg R, Vercruysse L, et al. The “Great Obstetrical Syndromes” are associated with disorders of deep placentation. Am J Obstet Gynecol. 2011;204(3):193-201.
  • 14. Lim KH, Zhou Y, Janatpour M, et al. Human cytotrophoblast differentiation/invasion is abnormal in pre-eclampsia. Am J Pathol. 1997;151(6):1809-18.
  • 15. Huppertz B. Placental origins of preeclampsia: challenging the current hypothesis. Hypertension. 2008;51(4):970-5.
  • 16. Robertson WB, Brosens I, Dixon HG. The pathological response of the vessels of the placental bed to hypertensive pregnancy. J Pathol Bacteriol. 1967;93(2):581-92.
  • 17. Gerretsen G, Huisjes HJ, Elema JD. Morphological changes of the spiral arteries in the placental bed in relation to pre-eclampsia and fetal growth retardation. Br J Obstet Gynaecol. 1981;88(9):876- 81.
  • 18. De Wolf F, Robertson WB, Brosens I. The ultrastructure of acute atherosis in hypertensive pregnancy. Am J Obstet Gynecol. 1975;123(2):164-74.
  • 19. Salafia CM, Pezzullo JC, Ghidini A, et al. Clinical correlations of patterns of placental pathology in preterm pre-eclampsia. Placenta. 1998;19(1):67-72.
  • 20. Redman CW, Sargent IL. Preeclampsia and the systemic inflammatory response. Semin Nephrol. 2004;24(6):565-70.
  • 21. Rusterholz C, Hahn S, Holzgreve W. Role of placentally produced inflammatory and regulatory cytokines in pregnancy and the etiology of preeclampsia. Semin Immunopathol. 2007;29(2):151- 62.
  • 22. Rabaglino MB, Conrad KP. Evidence for shared molecular pathways of dysregulated decidualization in preeclampsia and endometrial disorders revealed by microarray data integration. Faseb j. 2019;33(11):11682-11695.
  • 23. Gleicher N. Why much of the pathophysiology of preeclampsiaeclampsia must be of an autoimmune nature. Am J Obstet Gynecol. 2007;196(1):5.e1-7.
  • 24. Loke YW, King A. Immunology of implantation. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14(5):827-37.
  • 25. Santner-Nanan B, Peek MJ, Khanam R, et al. Systemic increase in the ratio between Foxp3+ and IL-17-producing CD4+ T cells in healthy pregnancy but not in preeclampsia. J Immunol. 2009;183(11):7023-30.
  • 26. Cincotta RB, Brennecke SP. Family history of pre-eclampsia as a predictor for pre-eclampsia in primigravidas. Int J Gynaecol Obstet. 1998;60(1):23-7.
  • 27. Mogren I, Högberg U, Winkvist A, et al. Familial occurrence of preeclampsia. Epidemiology. 1999;10(5):518-22.
  • 28. Tuohy JF, James DK. Pre-eclampsia and trisomy 13. Br J Obstet Gynaecol. 1992;99(11):891-4.
  • 29. McGinnis R, Steinthorsdottir V, Williams NO, et al. Variants in the fetal genome near FLT1 are associated with risk of preeclampsia. Nat Genet. 2017;49(8):1255-1260.
  • 30. Giannakou K, Evangelou E, Papatheodorou SI. Genetic and non-genetic risk factors for pre-eclampsia: umbrella review of systematic reviews and meta-analyses of observational studies. Ultrasound Obstet Gynecol. 2018;51(6):720-730.
  • 31. Alrahmani L, Willrich MAV. The Complement Alternative Pathway and Preeclampsia. Curr Hypertens Rep. 2018;20(5):40.
  • 32. Buyon JP, Kim MY, Guerra MM, et al. Predictors of Pregnancy Outcomes in Patients With Lupus: A Cohort Study. Ann Intern Med. 2015;163(3):153-63.
  • 33. Dvorak HF. Vascular permeability factor/vascular endothelial growth factor: a critical cytokine in tumor angiogenesis and a potential target for diagnosis and therapy. J Clin Oncol. 2002;20(21):4368-80.
  • 34. Burke SD, Zsengellér ZK, Khankin EV, et al. Soluble fmslike tyrosine kinase 1 promotes angiotensin II sensitivity in preeclampsia. J Clin Invest. 2016;126(7):2561-74.
  • 35. Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350(7):672-83.
  • 36. Venkatesha S, Toporsian M, Lam C, et al. Soluble endoglin contributes to the pathogenesis of preeclampsia. Nat Med. 2006;12(6):642-9.
  • 37. Roberts JM, Taylor RN, Goldfien A. Clinical and biochemical evidence of endothelial cell dysfunction in the pregnancy syndrome preeclampsia. Am J Hypertens. 1991;4(8):700-8.
  • 38. Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. Bmj 2005;330(7491):565.
  • 39. Bartsch E, Medcalf KE, Park AL, et al. Clinical risk factors for preeclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. Bmj. 2016;353:i1753.
  • 40. Chappell LC, Enye S, Seed P, et al. Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension: a prospective study. Hypertension. 2008;51(4):1002-9.
  • 41. Cunningham FG, Lindheimer MD. Hypertension in pregnancy. N Engl J Med. 1992;326(14):927-32.
  • 42. Walters BN. Preeclamptic angina--a pathognomonic symptom of preeclampsia. Hypertens Pregnancy. 2011;30(2):117-24.
  • 43. Zeeman GG. Neurologic complications of pre-eclampsia. Semin Perinatol. 2009;33(3):166-72.
  • 44. Mayama M, Uno K, Tano S, et al. Incidence of posterior reversible encephalopathy syndrome in eclamptic and patients with preeclampsia with neurologic symptoms. Am J Obstet Gynecol. 2016;215(2):239.e1-5.
  • 45. Errera MH, Kohly RP, da Cruz L. Pregnancy-associated retinal diseases and their management. Surv Ophthalmol. 2013;58(2):127-42.
  • 46. Roos NM, Wiegman MJ, Jansonius NM, et al. Visual disturbances in (pre)eclampsia. Obstet Gynecol Surv. 2012;67(4):242-50.
  • 47. Carpenter F, Kava HL, Plotkin D. The development of total blindness as a complication of pregnancy. Am J Obstet Gynecol. 1953;66(3):641-7.
  • 48. Crovetto F, Somigliana E, Peguero A, et al. Stroke during pregnancy and pre-eclampsia. Curr Opin Obstet Gynecol. 2013;25(6):425-32.
  • 49. Vaught AJ, Kovell LC, Szymanski LM, et al. Acute Cardiac Effects of Severe Pre-Eclampsia. J Am Coll Cardiol. 2018;72(1):1-11. 50. ACOG Committee Opinion number 313, September 2005. The
  • importance of preconception care in the continuum of women’s health care. Obstet Gynecol. 2005;106(3):665-6.
  • 51. Barton JR, O’Brien J M, Bergauer NK, et al. Mild gestational hypertension remote from term: progression and outcome. Am J Obstet Gynecol. 2001;184(5):979-83.
  • 52. Moran P, Baylis PH, Lindheimer MD, et al. Glomerular ultrafiltration in normal and preeclamptic pregnancy. J Am Soc Nephrol. 2003;14(3):648-52.
  • 53. Burrows RF, Kelton JG. Thrombocytopenia at delivery: a prospective survey of 6715 deliveries. Am J Obstet Gynecol. 1990;162(3):731-4.
  • 54. FitzGerald MP, Floro C, Siegel J, et al. Laboratory findings in hypertensive disorders of pregnancy. J Natl Med Assoc. 1996;88(12):794-8.
  • 55. Sagen N, Haram K, Nilsen ST. Serum urate as a predictor of fetal outcome in severe pre-eclampsia. Acta Obstet Gynecol Scand. 1984;63(1):71-5.
  • 56. Brown CE, Cunningham FG, Pritchard JA. Convulsions in hypertensive, proteinuric primiparas more than 24 hours after delivery. Eclampsia or some other cause? J Reprod Med. 1987;32(7):499-503.
  • 57. Richards A, Graham D, Bullock R. Clinicopathological study of neurological complications due to hypertensive disorders of pregnancy. J Neurol Neurosurg Psychiatry. 1988;51(3):416-21.
  • 58. Liu S, Joseph KS, Liston RM, et al. Incidence, risk factors, and associated complications of eclampsia. Obstet Gynecol. 2011;118(5):987-994.
  • 59. van Oostwaard MF, Langenveld J, Schuit E, et al. Recurrence of hypertensive disorders of pregnancy: an individual patient data metaanalysis. Am J Obstet Gynecol. 2015;212(5):624.e1-17.
  • 60. Benigni A, Gregorini G, Frusca T, et al. Effect of low-dose aspirin on fetal and maternal generation of thromboxane by platelets in women at risk for pregnancy-induced hypertension. N Engl J Med. 1989;321(6):357-62.
  • 61. Roberge S, Nicolaides KH, Demers S, et al. Prevention of perinatal death and adverse perinatal outcome using low-dose aspirin: a meta-analysis. Ultrasound Obstet Gynecol. 2013;41(5):491-9.
  • 62. Areia AL, Fonseca E, Areia M, et al. Low-molecular-weight heparin plus aspirin versus aspirin alone in pregnant women with hereditary thrombophilia to improve live birth rate: metaanalysis of randomized controlled trials. Arch Gynecol Obstet. 2016;293(1):81-86.
  • 63. Villar J, Purwar M, Merialdi M, et al. World Health Organisation multicentre randomised trial of supplementation with vitamins C and E among pregnant women at high risk for pre-eclampsia in populations of low nutritional status from developing countries. Bjog. 2009;116(6):780-8.
  • 64. De-Regil LM, Palacios C, Lombardo LK, et al. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2016; 14(1):Cd008873.
  • 65. Middleton P, Gomersall JC, Gould JF, et al. Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev. 2018;11(11):Cd003402.
  • 66. Kasawara KT, do Nascimento SL, Costa ML, et al. Exercise and physical activity in the prevention of pre-eclampsia: systematic review. Acta Obstet Gynecol Scand. 2012;91(10):1147-57.
  • 67. Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery: a systematic review. Jama. 2008;300(19):2286-96.
  • 68. Hofmeyr GJ, Lawrie TA, Atallah Á N, et al. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2018;10(10):Cd001059.
APA Cakir A, TEMİZ B (2023). Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. , 234 - 239. 10.37783/CRJ-0367
Chicago Cakir Akin,TEMİZ BİLAL ESAT Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. (2023): 234 - 239. 10.37783/CRJ-0367
MLA Cakir Akin,TEMİZ BİLAL ESAT Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. , 2023, ss.234 - 239. 10.37783/CRJ-0367
AMA Cakir A,TEMİZ B Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. . 2023; 234 - 239. 10.37783/CRJ-0367
Vancouver Cakir A,TEMİZ B Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. . 2023; 234 - 239. 10.37783/CRJ-0367
IEEE Cakir A,TEMİZ B "Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi." , ss.234 - 239, 2023. 10.37783/CRJ-0367
ISNAD Cakir, Akin - TEMİZ, BİLAL ESAT. "Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi". (2023), 234-239. https://doi.org/10.37783/CRJ-0367
APA Cakir A, TEMİZ B (2023). Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. Güncel Retina Dergisi, 7(3), 234 - 239. 10.37783/CRJ-0367
Chicago Cakir Akin,TEMİZ BİLAL ESAT Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. Güncel Retina Dergisi 7, no.3 (2023): 234 - 239. 10.37783/CRJ-0367
MLA Cakir Akin,TEMİZ BİLAL ESAT Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. Güncel Retina Dergisi, vol.7, no.3, 2023, ss.234 - 239. 10.37783/CRJ-0367
AMA Cakir A,TEMİZ B Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. Güncel Retina Dergisi. 2023; 7(3): 234 - 239. 10.37783/CRJ-0367
Vancouver Cakir A,TEMİZ B Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi. Güncel Retina Dergisi. 2023; 7(3): 234 - 239. 10.37783/CRJ-0367
IEEE Cakir A,TEMİZ B "Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi." Güncel Retina Dergisi, 7, ss.234 - 239, 2023. 10.37783/CRJ-0367
ISNAD Cakir, Akin - TEMİZ, BİLAL ESAT. "Preeklampsi ve Eklampsi (Gebelik Toksemisi): Patogenez, Tanı ve Tedavi". Güncel Retina Dergisi 7/3 (2023), 234-239. https://doi.org/10.37783/CRJ-0367