Prediction and prevention of preeclampsia

Keypoints

• Preeclampsia (PE) is an important cause of maternal and perinatal mortality worldwide, accounts for 10% to 15% of direct maternal deaths, and 99% of these deaths are in low-income countries.

• Preeclampsia is defined as systolic blood pressure of ≥140 mmHg and/or diastolic blood pressure of ≥90 mmHg on at least two occasions, measured four hours apart in previously normotensive women, and is accompanied by one or more of the following new-onset conditions after 20 weeks' gestation: (1) proteinuria, (2) evidence of other maternal organ dysfunction, or (3) uteroplacental dysfunction.

• Preeclampsia is classified into: (1) early PE (delivery < 34+0 weeks' gestation); (2) preterm PE (delivery < 37+0 weeks' gestation); (3) late-onset PE (delivery ≥ 34+0 weeks' gestation); (4) term PE (delivery ≥ 37+0 weeks' gestation).

• In Brazil, the incidence of PE varies from 1.5% to 7%; of preterm PE is 2% and of eclampsia is 0.6%. However, these statistics are likely to be underestimated and vary according to the region studied.

• Screening strategies for PE vary depending on the parameters used, pre-test risk, outcome stratification, and the gestational age at which screening is performed. However, there is consensus in the literature that no single-parameter screening test has been shown to adjust the preexisting maternal risk for PE with sufficient specificity and sensitivity for clinical use.

The National Specialized Commission on Ultrasonography in GO of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) endorses this document. The production of content is based on scientific evidence on the proposed theme and the results presented contribute to clinical practice.

Publikationsverlauf

Artikel online veröffentlicht:
06. März 2023

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