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CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(05): 318-332
DOI: 10.1055/s-0039-1687859
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Thieme Publicações Ltda Rio de Janeiro, Brazil

Pre-eclampsia/Eclampsia

Pré-eclâmpsia/Eclâmpsia
José Carlos Peraçoli 
1   Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
,
Vera Therezinha Medeiros Borges
1   Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
,
José Geraldo Lopes Ramos
2   Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Ricardo de Carvalho Cavalli
3   Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Sérgio Hofmeister de Almeida Martins Costa
2   Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Leandro Gustavo de Oliveira
1   Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
,
Francisco Lazaro Pereira de Souza
4   Department of Tocoginecology, Centro Universitário Lusíada, Santos, SP, Brazil
,
Henri Augusto Korkes
5   Department of Obstetrics and Gynecology, Faculty of Medicine, Pontifícia Universidade Católica de São Paulo, São Paulo, SP, Brazil
,
Ione Rodrigues Brum
6   Department of Maternal and Child Health, Faculty of Medicine, Universidade Federal do Amazonas, Manaus, AM, Brazil
,
Maria Laura Costa
7   Department of Gynecology and Obstetrics, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Mário Dias Corrêa Junior
8   Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
,
Nelson Sass
9   Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Angélica Lemos Debs Diniz
10   Department of Obstetrics and Gynecology, Faculty of Medicine, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
,
Caio Antonio de Campos Prado
3   Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Edson Viera da Cunha Filho
11   Gynecology and Obstetrics Training Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
› Author Affiliations
Further Information

Publication History

Publication Date:
10 June 2019 (online)

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Pre-eclampsia/EclampsiaRev Bras Ginecol Obstet 2019; 41(05): e1-e2
DOI: 10.1055/s-0040-1702167

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 20th 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 20a 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
 

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