medigraphic.com

2008, Número S2

<< Anterior

Arch Cardiol Mex 2008; 78 (S2)


Hipertensión arterial sistémica en el embarazo

Rosas M, Lomelí C, Mendoza-González C, Lorenzo JA, Méndez A, Férez SSM, Attie F

Idioma: Español
Referencias bibliográficas: 36
Paginas: 104-108
Archivo PDF: 104.09 Kb.


RESUMEN

La evidencia acumulada indica que la hipertensión en el embarazo es una entidad subdiagnosticada y frecuentemente no bien tratada, dando origen a complicaciones cardiovasculares graves. La hipertensión que ocurre durante la gestación puede dar lugar a preeclampsia o a situaciones graves como la eclampsia y el síndrome de HELLP. Además se reconoce que las mujeres que desarrollaron hipertensión durante la gestación, tienen incremento en la posibilidad de desarrollar eventos cardiovasculares mayores, aun cuando la presión arterial haya vuelto a cifras normales en el postparto. De acuerdo con nuestras recomendaciones, la mujer con hipertensión gestacional debe tener mayor vigilancia y someterse a estudios de estratificación de riesgo cardiovascular por lo menos una vez al año. Si además se asocia a obesidad y otros factores de riesgo cardiovascular su probabilidad de desarrollar eventos graves después de la menopausia han sido sugeridos. En estas guías presentamos las hipótesis más recientes y algunas recomendaciones para su manejo integral.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. ACOG Committee on Practice Bulletins-Obstetrics: Diagnostic and management of preeclampsia and eclampsia. Obstet Gynecol 2001; 98: 159-167.

  2. Hauth MG, Ewell RL, Levine JR, Esterlitz BM, Sibai, Curet LB, Curet: Pregnancy outcomes in healthy nulliparas women who subsequently developed hypertension. Obstet Gynecol 2000; 95: 24-28.

  3. Knuist M, Bonsel GJ, Zondervan HA, Treffers PE: Intensification of fetal and maternal surveillance in pregnant women with hypertensive disorders. Int J Gynecol Obstet 1998; 61: 127.

  4. Report of the National High Blood Pressure Education Program. Working group report on high blood pressure in pregnancy. Am J Obstet Gynecol 2000; 183: S1-22.

  5. Buchbinder A, Sibai BM, Caritis S, Macpherson C, Hauth J, Lindheimer MD: Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol 2002; 186: 66-71.

  6. Hnat MD, Sibai BM, Caritis S, Hauth J, Lindheimer MD, MacPherson C: Perinatal outcome in women with recurrent preeclampsia compared with women who develop preeclampsia as nulliparas. Am J Obstet Gynecol 2002; 186: 422-426.

  7. Barton JR, O’Brien JM, Bergauer NK, Jacques DL, Sibai BM: Mild gestational hypertension remote from term: progression and outcome. Am J Obstet Gynecol 2001; 184: 979-983.

  8. Meyer NL, Mercer BM, Friedman SA, Sibai BM: Urinary dipstick protein: A poor predictor of absent or severe proteinuria. Am J Obstet Gynecol 1994; 170: 137-141.

  9. Sibai BM, Caritis S, Hauth J, Lindheimer MD, MacPherson C, Klebanoff M, et al: Hypertensive disorders in twin versus singleton gestations. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol 2000; 182: 938-942.

  10. Dekker GA, Sibai BM: Pathogenesis and etiology of preeclampsia. Am J Obstet Gynecol 1998; 179: 1359.

  11. Friedman SA, Lindheimer MD: Prediction and differential diagnostic. In: M.D. Lindheimer, J.M. Roberts and F.G. Cunningham, Editors, Chesley’s hypertensive disorders in pregnancy, Appleton and Lange, Stamford, Connecticut 1999: 201-227.

  12. Sibai BM: Prevention of preeclampsia: A big disappointment. Am J Obstet Gynecol 1998; 179: 1275-1278.

  13. Levine RJ, Hauth JC, Curet LB, Sibai BM, Catalano PM, Morris CD: Trial of calcium to prevent preeclampsia. N Engl J Med 1997; 337: 69-76.

  14. Duley L, Henderson-Smart D, Knight M, King J: Antiplatelet drugs for prevention of pre-eclampsia and its consequences: Systemic review. BMJ 2001; 322: 329-333.

  15. Caritis S, Sibai B, Hauth J, Lindheimer MD, Klebanoff M, Thom E: Low-dose aspirin to prevent preeclampsia in women at high risk. N Engl J Med 1998; 338: 701-705.

  16. Chappell LC, Seed PT, Briley AL, Kelly FL, Lee R, Hunt BJ: Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: A randomized trial. Lancet 1999; 354: 810-816.

  17. Coomarasamy A, Papaioannou S, Gee H, Khan KS: Aspirin for the prevention of preeclampsia in women with abnormal uterine artery Doppler: A meta-analysis. Obstet Gynecol 2001; 98: 861-866.

  18. Sibai BM, Villar MA, Mabie BC: Acute renal failure in hypertensive disorders of pregnancy. Am J Obstet Gynecol 1990; 162: 777-783.

  19. Barton JR, Witlin AG, Sibai BM: Management of mild preeclampsia. Clin Obstet Gynecol 1999; 42: 465-469.

  20. Magee LA, Ornstein MP, Von Dadelszen P: Fortnightly review: Management of hypertension in pregnancy. BMJ 1999: 318: 1332-1336.

  21. Barron WM, Heckerling P, Hibbard JU, Fisher S: Reducing unnecessary coagulation testing in hypertensive disorders of pregnancy. Obstet Gynecol 1999; 94: 364-370.

  22. Friedman SA, Lubarsky S, Schiff E: Expectant management of severe preeclampsia remote from term. Clin Obstet Gynecol 1999; 42: 470-478.

  23. Amorim MMR, Santas LC, Faundes A: Corticosteroid therapy for prevention of respiratory distress syndrome in severe preeclampsia. Am J Obstet Gynecol 1999; 180: 1283-1288.

  24. Schiff E, Friedman SA, Sibai BM: Conservative management of severe preeclampsia remote from term. Obstet Gynecol 1994; 84: 620-630.

  25. Hogg B, Hauth JC, Caritis SN, Sibai BM, Lindheimer M, Van Dorsten JP, et al: Safety of labor epidural anesthesia for women with severe hypertensive disease. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol 1999; 181: 1096-1101.

  26. Head BB, Owen J, Vincent RD, Shih G Jr., Chestnut DH, Hauth JC: A randomized trial of intrapartum analgesia in women with severe preeclampsia. Obstet Gynecol 2002; 99: 452-457.

  27. Coetzee EJ, Dommisse J, Anthony J: A randomized controlled trial of intravenous magnesium sulfate versus placebo in the management of women with severe preeclampsia. Br J Obstet Gynaecol 1998; 105: 300-303.

  28. The Magpie Trial Collaborative Group: Do women with pre-eclampsia, and their babies, benefit from magnesium sulfate? The Magpie trial: A randomized placebo-controlled trial. Lancet 2002; 359: 1877-1890.

  29. Witlin AG, Friedman SA, Sibai BM: The effect of magnesium sulfate therapy on the duration of labor in women with mild preeclampsia at term: A randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol 1997; 176: 623-627.

  30. Livingston JC, Livingston LW, Ramsey R, Mabie BC, Sibai BM: Magnesium sulfate in women with mild preeclampsia: A randomized, double blinded, placebo-controlled trial. Obstet Gynecol 2003; 101: 217-220.

  31. Duley L, Henderson-Smart DJ: Drugs for rapid treatment of very high blood pressure during pregnancy (Cochrane Review). Cochrane Library 2003; 2.

  32. Ferrazani S, DeCarolis S, Pomini F, Testa AC, Mastromarino C, Caruso A: The duration of hypertension in the puerperium of preeclamptic women: Relationship with renal impairment and week of delivery. Am J Obstet Gynecol 1994; 17: 506-512.

  33. Walters BNJ, Walters T: Hypertension in the puerperium. Lancet 1987; 2: 330.

  34. Barton JR, Hiett AK, Conover WB: The use of nifedipine during the postpartum period in patients with severe preeclampsia. Am J Obstet Gynecol 1990; 162: 788-792.

  35. Witlin AG, Mattar F, Sibai BM: Postpartum stroke: A twenty-year experience. Am J Obstet Gynecol 2000; 183: 83-88.

  36. Chames MC, Livingston JC, Ivester TS, Barton JR, Sibai BM: Late postpartum eclampsia: A preventable disease? Am J Obstet Gynecol 2002; 186: 1174-1177.




2020     |     www.medigraphic.com