Understanding of current clinical approaches to gestational hypertensive syndromes

Abstract

Gestational Hypertensive Syndromes (GHS) are a significant complication in obstetrics, affecting approximately 16% of pregnancies, with preeclampsia (PE) being one of the most prevalent, affecting between 3% and 10% of pregnant women. PE is characterized by hypertension and organ damage after 20 weeks of gestation, and can become even more complicated when superimposed on chronic hypertension, especially in women with preexisting kidney diseases. Eclampsia, marked by tonic-clonic seizures or coma, occurs in pregnant women with no history of other neurological conditions, and is one of the most severe manifestations of PE. This study reviews the current clinical approaches to PE, based on the analysis of 160 articles published between 2015 and 2024, with descriptors such as "Approach", "Clinical", and "Gestational Hypertensive Syndrome". Nulliparity appears as an important risk factor for the development of hypertensive disorders in pregnancy. Although antihypertensive treatment is widely used, it remains controversial, with debates about its effectiveness in preventing serious complications such as placental abruption, second-trimester fetal loss, and preterm birth. In the management of PE, the focus is on preventing maternal and perinatal morbidity and mortality, through tight blood pressure control, prevention of eclampsia, and continuous monitoring of fetal well-being. Early identification of laboratory complications, such as HELLP syndrome, is crucial for adequate management, seeking to balance maternal-fetal risks with the challenges of prematurity. An in-depth understanding of GHS and the adoption of a multidisciplinary approach are essential to mitigate negative impacts on the health of the mother and fetus, ensuring timely and effective intervention.

DOI:https://doi.org/10.56238/sevened2024.024-008