Hipertenzija u trudnoći

master's thesis

• Title (english): Hypertension in pregnancy
• Author: Iva Tokić
• Mentor: Diana Delić-Brkljačić (mentor)
• Committee member: Nikola Bulj (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Diana Delić-Brkljačić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Hipertenzija u trudnoći klasificira se u četiri tipa: kronična hipertenzija, gestacijska hipertenzija, preeklampsija/eklampsija i preeklampsija superponirana na kroničnu hipertenziju. Komplicira 5-10 % svih trudnoća i među glavnim je čimbenicima morbiditeta i mortaliteta majke i djeteta. Neki od rizičnih čimbenika za ovaj spektar bolesti su: nuliparnost, dob>40 ili <18, višeplodna trudnoća, pretilost i šećerna bolest. Liječenje obuhvaća promjenu životnih navika (prehrana, tjelovježba) i primjenu antihipertenziva. Najčešće primjenjivani antihipertenzivi koji su sigurni u trudnoći su labetalol, metildopa i nifedipin. Uz njih se u hitnom snižavanju krvnog tlaka koristi i hidralazin. Apsolutno kontraindicirani lijekovi su ACEi/ARB (inhibitor angiotenzin konvertirajućeg enzima/blokatori angiotenzinskih receptora) jer uzrokuju fetalne malformacije različitih organskih sustava. Kao posljedica neliječene hipertenzije može doći do intrauterinog zastoja rasta, abrupcije placente, neonatalne smrti, odnosno postpartalnog krvarenja, moždanog udara i renalne insuficijencije u majke. Dokazano je da svi oblici hipertenzije u trudnoći nose rizik od razvoja kardiovaskularnih bolesti (hipertenzije, infarkta miokarda, zatajenja srca) u budućnosti pa postoji potreba za edukacijom tih bolesnica, ali i osiguravanje dobre zdravstvene skrbi nakon završetka trudnoće u vidu skrininga kod obiteljskih liječnika i kardiologa.

Abstract (english)

Hypertension in pregnancy is classified into four types: chronic hypertension, gestational hypertension, preeclampsia/eclampsia and chronic hypertension with superimposed preeclampsia. It affects as many as 5-10 % pregnancies worldwide and is one of main factors of maternal and perinatal morbidity and mortality. Some risk factors are: nulliparity, age>40 or <18, multifetal pregnancy, obesity and diabetes. The treatment involves lifestyle modifications (diet, exercise) and the use of drugs. Most frequently used drugs which are also safe and recommended in pregnancy are labetalol, methyldopa and nifedipine. Together with them, hydralazine is also used in the acute management of hypertension emergency. Medicines which are absolutely contraindicated are ACEi/ARB (angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers) because they can cause fetal malformations in different organ system. Untreated hypertension in pregnancy can lead to fetal growth restriction, abruption, neonatal death that is postpartal hemorrhage, stroke and renal insufficiency in mother. It has been proven that all hypertensive disorders in pregnancy carry the risk of cardiovascular disease (hypertension, myocardial infarction, heart failure) in future so there is need for education of these patients, but also ensuring good health care upon the completion of pregnancy in the form of screening by their family medicine doctor and cardiologists.

• Keywords: hipertenzija; trudnoća; komplikacije; liječenje
• Keywords (english): hypertension; pregnancy; complications; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:571966
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-03-20 09:11:30