# 116.1 Pré-eclâmpsia e eclâmpsia - Parte I

Summary

This video script covers the important topic of preeclampsia and eclampsia in pregnancy, explaining their types, risks, and treatment. Preeclampsia is characterized by high blood pressure and organ dysfunction, with various subtypes based on the timing of onset and severity. The script outlines risk factors, such as pre-existing conditions and age, and highlights the challenges of early detection. Preventive measures like aspirin and calcium supplementation are recommended, particularly for high-risk pregnant women. The video also emphasizes the importance of regular check-ups to monitor blood pressure and other signs of the condition.

Takeaways

• 😀 Pre-eclampsia is a syndrome characterized by hypertension associated with proteinuria or organ dysfunction, typically occurring after 20 weeks of gestation or in the postpartum period.
• 😀 The incidence of pre-eclampsia is 4.6% of pregnancies worldwide.
• 😀 There are various subtypes of pre-eclampsia: early-onset (before 34 weeks), late-onset (after 34 weeks), and pre-existing chronic hypertension worsened during pregnancy.
• 😀 Severe pre-eclampsia may develop into HELLP syndrome, which involves hemolysis, elevated liver enzymes, and thrombocytopenia.
• 😀 Eclampsia refers to seizures in a patient with pre-eclampsia, with no other neurological conditions involved.
• 😀 The pathophysiology of pre-eclampsia involves maternal, fetal, and placental factors, leading to vascular changes and systemic dysfunction in the mother.
• 😀 Risk factors for pre-eclampsia include a history of pre-eclampsia, multifetal pregnancy, chronic kidney disease, autoimmune diseases, diabetes, and chronic hypertension.
• 😀 Moderate risk factors include being a first-time mother, maternal age over 35, obesity (BMI > 30), and a family history of pre-eclampsia.
• 😀 Identifying pre-eclampsia risk early in pregnancy through screening and regular blood pressure monitoring is crucial for maternal health.
• 😀 The American College of Obstetricians and Gynecologists recommends aspirin (81 mg daily) for high-risk pregnant women starting between 12 and 28 weeks of gestation until delivery.
• 😀 The Brazilian Network for Pregnancy Hypertension suggests using 100 mg of aspirin at night for high-risk women starting from the 12th week of gestation, continuing until the 32nd week, along with calcium supplementation for those with low intake.

Q & A

What is pre-eclampsia?

Pre-eclampsia is a syndrome characterized by high blood pressure, associated with proteinuria or dysfunction of target organs, typically occurring after 20 weeks of gestation or in the postpartum period.

What is the global incidence rate of pre-eclampsia?

The global incidence of pre-eclampsia is 4.6% of all pregnancies.

What are the subtypes of pre-eclampsia?

There are several subtypes of pre-eclampsia, including early-onset pre-eclampsia (before 34 weeks), late-onset pre-eclampsia (after 34 weeks, which accounts for 85% of cases), pre-eclampsia superimposed on chronic hypertension, and the HELLP syndrome.

What is HELLP syndrome?

HELLP syndrome is a severe subtype of pre-eclampsia, characterized by hemolysis, elevated liver enzymes, and thrombocytopenia.

What defines eclampsia?

Eclampsia refers to the occurrence of a tonic-clonic seizure in a patient with pre-eclampsia, without other neurological conditions.

What are the causes of pre-eclampsia?

The exact cause of pre-eclampsia is not fully understood, but it involves both maternal and fetal placental factors. Poor placental blood flow leads to the release of anti-angiogenic factors into the maternal circulation, causing systemic dysfunction and hypertension.

What are the risk factors for pre-eclampsia?

High-risk factors include a history of pre-eclampsia, multifetal pregnancies, chronic kidney disease, autoimmune diseases, type 1 or type 2 diabetes, and chronic hypertension. Moderate risk factors include first pregnancies, maternal age over 35, a body mass index greater than 30, and a family history of pre-eclampsia.

How can pre-eclampsia be prevented?

Prevention involves early screening for risk factors during the first prenatal consultation, blood pressure monitoring, and the use of prophylactic medications. Aspirin (81 mg/day) is recommended for high-risk pregnancies starting between 12-28 weeks of gestation, continuing until delivery. In Brazil, the use of the antihypertensive drug peniana (100 mg) starting at 12 weeks is also recommended, along with calcium supplementation in high-risk populations.

What are the benefits of calcium supplementation in preventing pre-eclampsia?

Calcium supplementation is recommended for pregnant women at high risk of pre-eclampsia, especially those with low calcium intake. It is suggested to start supplementation in the first trimester and continue until the end of pregnancy to help reduce the risk of developing the condition.

What role does teleconsultation play in managing pre-eclampsia?

Teleconsultation platforms provide a way for patients to receive further advice and management for pre-eclampsia, particularly for those who may not have easy access to in-person care.