Title | Pre-eclampsia: an update. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | von Dadelszen, P, Magee, LA |
Journal | Curr Hypertens Rep |
Volume | 16 |
Issue | 8 |
Pagination | 454 |
Date Published | 2014 Aug |
ISSN | 1534-3111 |
Keywords | Aspirin, Blood Pressure, Female, Humans, Magnesium, Pre-Eclampsia, Pregnancy, Risk |
Abstract | Pre-eclampsia remains the second leading direct cause of maternal death, >99 % of which occurs in less developed countries. Over 90 percent of the observed reduction in pre-eclampsia-related maternal deaths in the UK (1952-2008) occurred with antenatal surveillance and timed delivery. In this review, we discuss the pathogenesis, diagnostic criteria, disease prediction models, prevention and management of pre-eclampsia. The Pre-eclampsia Integrated Estimate of RiSk (PIERS) models and markers of angiogenic imbalance identify women at incremental risk for severe pre-eclampsia complications. For women at high risk of developing pre-eclampsia, low doses of aspirin (especially if started <17 weeks) and calcium are evidence-based preventative strategies; heparin is less so. Severe hypertension must be treated and the Control of Hypertension In Pregnancy (CHIPS) Trial (reporting: 2014) will guide non-severe hypertension management. Magnesium sulfate prevents and treats eclampsia; there is insufficient evidence to support alternative regimens. Pre-eclampsia predicts later cardiovascular disease; however, at this time we do not know what to do about it. |
DOI | 10.1007/s11906-014-0454-8 |
Alternate Journal | Curr. Hypertens. Rep. |
Citation Key | 619 |
PubMed ID | 24915961 |
Grant List | / / Canadian Institutes of Health Research / Canada |