Hipertensão Arterial na Mulher Grávida
DOI:
https://doi.org/10.24950/rspmi.537Palavras-chave:
Eclâmpsia, Fatores de Risco de Doenças Cardíacas, Gravidez, Hipertensão, Pré-EclâmpsiaResumo
Os distúrbios hipertensivos da gravidez continuam a ser
causa de morbilidade e mortalidade materna e fetal, não
só na gravidez e peri-parto, mas também na vida futura da
mãe e do bebé. É fundamental não só entender os mecanismos fisiopatológicos de base, mas também saber proceder
ao diagnóstico com a metodologia adequada, avaliação de
risco da mulher, e conhecer as opções terapêuticas particulares desta condição. A vigilância tem em conta os vários
tipos de distúrbios hipertensivos, visto o risco de evolução
para condições potencialmente graves e/ou fatais pode ter
consequências catastróficas. Este artigo procura rever a Hipertensão arterial na mulher grávida em todos os aspetos
fundamentais, para a abordagem mais adequada do ponto
de vista do internista.
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Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39:3165-241. doi: 10.1093/eurheartj/ehy340.
Bramham K, Parnell B, Nelson-Piercy C, Seed P T, Poston L, Chappell L C et al. Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis BMJ 2014; 348: g2301 doi:10.1136/bmj.g2301
McLaughlin K et al. Phenotypes of Pregnant Women who subsequently Develop Hypertension in Pregnancy. Journal of the American Heart Association. 2018;7:e009595. doi: 10.1161/JAHA.118.009595
Marilucy Lopez-Sublet, Bernard Lévy. Pré-éclampsie : maladie vasculaire majeure, physiopathologie, développements récents. Sang Thrombose Vaisseaux. 2018;30(4):161-9. doi:10.1684/stv.2018.1031
Brouwers L, van der Meiden-van Roest AJ, Savelkoul C, Vogelvang TE, Lely AT, Franx A, van Rijn BB. Recurrence of pre-eclampsia and the risk of future hypertension and cardiovascular disease: a systematic review and meta- -analysis. BJOG. 2018. doi: 10.1111/1471-0528.15394.
Cífková R, Johnson MR, Kahan T, Brguljan J, Williams B, Coca A, et al. Peripartum management of hypertension: a position paper of the ESC Council on Hypertension and the European Society of Hypertension. Eur Heart J Cardiovasc Pharmacother. 2020. doi: 10.1093/ehjcvp/pvz082.
Garovic VD, Dechend R, Easterling T, Karumanchi SA, McMurtry Baird S, Magee LA, Rana S, et al. American Heart Association Council on Hypertension; Council on the Kidney in Cardiovascular Disease, Kidney in Heart Disease Science Committee; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; and Stroke Council. Hypertension in Pregnancy: Diagnosis, Blood Pressure Goals, and Pharmacotherapy: A Scientific Statement From the American Heart Association. Hypertension. 2022. doi: 10.1161/HYP.0000000000000208.
Chahine KM, Sibai BM. Chronic Hypertension in Pregnancy: New Concepts for Classification and Management. Am J Perinatol. 2019:161-168. doi: 10.1055/s-0038-1666976.
Paauw ND, Lely AT. Cardiovascular Sequels During and After Preeclampsia. Advances in Experimental Medicine and Biology. 2018;1065:455-470. doi: 10.1007/978-3-319-77932-4_28.
Stanhewicz AE. Residual vascular dysfunction in women with a history of preeclampsia. Am J Physiol Regul Integr Comp Physiol. 2018; 315:R1062- -R1071. doi: 10.1152/ajpregu.00204.2018.
Odigboegwu O, Pan LJ, Chatterjee P. Use of Antihypertensive Drugs During Preeclampsia. Front Cardiovasc Med. 2018;5:50. doi: 10.3389/ fcvm.2018.00050.
Armaly Z, Jadaon JE, Jabbour A and Abassi ZA Preeclampsia: Novel Mechanisms and Potential Therapeutic Approaches. Front Physiol. 2018 9:973. doi: 10.3389/fphys.2018.00973
Novelli GP, Vasapollo B, Valensise H. Hemodynamic Prediction and Stratification of Hypertensive Disorders of Pregnancy: A Dream that is Coming True. J Am Heart Assoc. 2018, 7:e010084. doi: 10.1161/JAHA.118.010084
Ramlakhan KP, Johnson MR, Roos-Hesselink JW. Pregnancy and cardiovascular disease. Nat Rev Cardiol. 2020;17:718-31. doi: 10.1038/s41569- 020-0390-z.
Alan T, Tita MD, Ph D, Jeff M, Szychowski et al. for the Chronic Hypertension and Pregnancy (CHAP) Trial Consortium. Treatment for Mild Chronic Hypertension during Pregnancy. NEJM 2022; 386:1781-1792. doi: 10.1056/NEJMoa2201295.
Shekhar S, Gupta N, Kirubakaran R, Pareek P. Oral nifedipine versus intravenous labetalol for severe hypertension during pregnancy: a systematicreview and meta-analysis. BJOG. 2016;123:40-7. doi: 10.1111/1471- 0528.13463.
Yin J, Mei Z, Shi S, Du P, Qin S. Nifedipine or amlodipine? The choice for hypertension during pregnancy: a systematic review and meta-analysis. Arch Gynecol Obstet. 2022 (in press). doi: 10.1007/s00404-022-06504-5.
Timpka, S., Fraser, A., Schyman, T. et al. The value of pregnancy complication history for 10-year cardiovascular disease risk prediction in middle-aged women. Eur J Epidemiol. 2018; 33: 1003–10 . doi: 10.1007/ s10654-018-0429-1
Theilen LH. Preeclampsia and cardiovascular risk: comparing apples to apples. Mini-commentary. BJOG. 2018;125:1655. doi: 10.1111/1471- 0528.15425.
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Direitos de Autor (c) 2022 Medicina Interna
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
Direitos de Autor (c) 2023 Medicina Interna
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