PREECLAMPSIA RISK FACTORS, DIAGNOSIS, MANAGEMENT

Abstract

Abstract Hypertensive disorders of pregnancy affect up to 10% of pregnancies
worldwide, which includes the 3%–5% of all pregnancies complicated by
preeclampsia. Preeclampsia is defined as new onset hypertension after 20 weeks’
gestation with evidence of maternal organ or uteroplacental dysfunction or proteinuria.
Despite its prevalence, the risk factors that have been identified lack accuracy in
predicting its onset and preventative therapies only moderately reduce a woman’s risk
of preeclampsia. Preeclampsia is a major cause of maternal morbidity and is associated
with adverse foetal outcomes including intra-uterine growth restriction, preterm birth,
placental abruption, foetal distress, and foetal death in utero. At present, national
guidelines for foetal surveillance in preeclamptic pregnancies are inconsistent, due to
a lack of evidence detailing the most appropriate assessment modalities as well as the
timing and frequency at which assessments should be conducted. Current management
of the foetus in preeclampsia involves timely delivery and prevention of adverse effects
of prematurity with antenatal corticosteroids and/or magnesium sulphate depending on
gestation. Alongside the risks to the foetus during pregnancy, there is also growing
evidence that preeclampsia has long-term adverse effects on the offspring. In
particular, preeclampsia has been associated with cardiovascular sequelae in the
offspring including hypertension and altered vascular function.