Preeklampsija i perinatalni ishod

master's thesis

• Title (english): Preeclampsia and perinatal outcome
• Author: Marina Baran
• Mentor: Josip Juras (mentor)
• Committee member: Mato Pavić (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Josip Juras (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Preeklampsija je multisistemna bolest trudnica koja se definira kao novonastala hipertenzija s proteinurijom, organskim zatajenjem ili oboje nakon 20. tjedna gestacije. Može zahvatiti mozak, bubrege, jetru, hematološki sustav, pluća i posteljicu. Dijeli se na antenatalnu, koja može biti rana ako se javi prije 34. tjedna gestacije ili kasna ako se javi u ili nakon 34. tjedna gestacije, te na postnatalnu preeklampsiju. Smatra se da je preeklampsija posljedica loše implantacije placente i imunoloških mehanizama koji uzrokuju upalne promjene krvnih žila i endotelnu disfunkciju. Najčešći perinatalni ishodi preeklampsije su prijevremeni porod i intrauterini zastoj rasta, a može uzrokovati i mrtvorođenost. Dva su različita fenotipa preeklampsije: preeklampsija s intrauterinim zastojem rasta i preeklampsija bez intrauterinog zastoja rasta. Preeklampsiju s intrauterinim zastojem rasta fetusa karakterizira mali srčani minutni volumen i visoki periferni vaskularni otpor, za razliku od preeklampsije bez intrauterinog zastoja rasta koju karakterizira veliki srčani minutni volumen i niski periferni vaskularni otpor. Acetilsalicilna kiselina je jedina dokazano djelotvorna terapija za prevenciju preeklampsije. Ako se preeklampsija pojavi u 37. tjednu gestacije ili kasnije, porod je jedini pravilan izbor liječenja. Dosadašnje smjernice liječenja preeklampsije preporučaju upotrebu antihipertenziva za snižavanje krvnog tlaka. Hipoteza o dva fenotipa preeklampsije nudi mogućnost individualiziranog pristupa terapiji, ovisno o hemodinamskim parametrima majke.

Abstract (english)

Preeclampsia is a multisystem pregnancy disease defined as new onset hypertension with proteinuria, organ dysfunction, or both after 20 weeks gestation. It can affect the brain, the kidneys, the liver, the hematological system, the lungs, and the placenta. Preeclampsia can be classified as antenatal, early antenatal if it occurs before 34 weeks gestation, late antenatal if it occurs at 34 weeks or later, and postnatal. Preeclampsia is believed to be caused by poor placental implantation and immunological involvement which cause vascular inflammation and endothelial dysfunction. Preterm birth and intrauterine growth restriction are among the most common perinatal outcomes of preeclampsia. It can also cause stillbirth. There are two different phenotypes of preeclampsia: preeclampsia with fetal growth restriction and preeclampsia without fetal growth restriction. Preeclampsia with fetal growth restriction is characterized by low cardiac output and high peripheral vascular resistance, whereas preeclampsia without fetal growth restriction is characterized by high cardiac output and low peripheral vascular resistance. Acetylsalicylic acid is the only evidence-based preventive drug treatment for preeclampsia. Should preeclampsia occur at 37 weeks gestation or later, initiating birth is the only suitable therapy. Preeclampsia management protocols suggest antihypertensive drug therapy to reduce blood pressure. The hypothesis of two phenotypes of preeclampsia offers personalized therapy approach possibilities depending on the cardiac parameters of the mother.

• Keywords: preeklampsija; perinatalni ishod; intrauterini zastoj rasta; srčani minutni volumen; postapartalna preeklampsija; prevencija
• Keywords (english): Preeclampsia; Perinatal outcome; Cardiac output; Intrauterine growth restriction; Postpartal preeclampsia; prevention
• Language: croatian
• URN:NBN: urn:nbn:hr:105:012037
• 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: 2023-10-20 10:47:21