Advisor(s)
Abstract(s)
Introdução: A hipertensão arterial é uma das patologias mais comuns na gravidez, tendo
repercussões tanto para a saúde materna como para o desenvolvimento do feto. Com uma
prevalência, aproximada, de 10% em todas as gestações, torna-se imperativo o seu diagnóstico
precoce, bem como a eficácia dos procedimentos terapêuticos.
Definida pelo Colégio Americano de Obstetras e Ginecologistas (ACOG) como a pressão arterial
sistólica =140 mmHg e/ou a diastólica =90 mmHg, esta, pode dividir-se em 4 grandes grupos: préeclâmpsia,
hipertensão gestacional, hipertensão crónica e hipertensão crónica com sobreposição de
eclâmpsia.
Distintas e até então, escassamente cógnitas, alterações fisiopatológicas como diminuição do fluxo
materno-fetal, aspetos imunogenéticos, uma provável presença do gene da produção do óxido
nítrico e do sistema HLA, alterações endoteliais e, consequente má adaptação placentária estarão
associadas a esta intercorrência na gravidez.
As medidas terapêuticas empregues deverão acordar a eficácia medicamentosa com as mínimas
consequências exequíveis para o feto. Sabe-se também que apesar de alguns fármacos conseguirem
efetivamente diminuir a pressão arterial, a única solução efetiva em síndromes hipertensivas como
a pré-eclampsia e a hipertensão induzida pela gravidez é o parto.
Objetivos: Investigar e analisar, de forma crítica, a literatura sobre diversos mecanismos
fisiopatológicos que têm vindo a ser estudados como causas que despoletam a hipertensão durante
a gravidez, bem como as particularidades terapêuticas associadas a esta patologia, incluindo os
benefícios e riscos de determinados fármacos. Pretende-se ainda enfatizar o exercício do
profissional de saúde como impulsionador fundamental no aconselhamento de adoção de estilos de
vida saudáveis, havendo um foco na prevenção da hipertensão.
Métodos: Para esta revisão, foi efetuada uma vasta pesquisa bibliográfica cujas fontes se
fundamentaram, maioritariamente na PubMED, ScienceDirect, as guidelines da Sociedade
Portuguesa de Hipertensão em www.sphta.orgh.pt e as normas da Direção Geral de Saúde em
https://www.dgs.pt/upload/membro.id/ficheiros/i006254.pdf.
Conclusão: A hipertensão arterial requer indubitavelmente uma atenção contínua
atendendo às consequências que poderá acarretar não só para a mãe, mas também para o feto. A
deteção de uma mulher com patologia hipertensiva que esteja grávida faz com que esta seja
imediatamente referenciada para Consulta de Alto Risco Obstétrico.
Introduction: Hypertension is one of the most common pathologies in pregnancy, with repercussions for both maternal health and fetal development. With an approximate prevalence of 10% in all pregnancies, it becomes imperative to have a prior diagnosis as well efficient therapeutic procedures. Defined by the American College of Obstetricians and Gynecologists (ACOG) as systolic blood pressure> 140 mmHg and / or diastolic> 90 mmHg, it can be divided into 4 main groups: preeclampsia, gestational hypertension, chronic hypertension and hypertension with overlapping eclampsia. Distinct and until then, scarcely known, respiratory fistulae such as decreased maternal-fetal flow, immunogenetic aspects, a probable presence of the gene for the production of nitric oxide and HLA, endothelial system and consequently placental maladaptation will be associated with this intercurrence in the pregnancy. The therapeutic measures should be employed according to the drug efficacy with the least achievable consequences for the fetus. It is also known that although some drugs can effectively lower blood pressure, a single effective solution in hypertensive syndromes such as preeclampsia and pregnancy-induced hypertension is childbirth. Objectives: To investigate and critically analyze a literature on several physiopathological mechanisms that have been studied as causes that trigger hypertension during pregnancy, as well as therapeutic specialties associated with this pathology, including the benefits and risks of certain drugs. It is also intended to emphasize the exercise of the health professional as a fundamental impeller in the counseling of adoption of healthy lifestyles, with a focus on the prevention of hypertension. Methods: For this review, a large bibliographical research was carried out which sources were based mainly on PubMED, ScienceDirect, as guidelines of the Portuguese Society of Hypertension in www.sphta.orgh.pt and as norms of the General Directorate of Health at https: / /www.dgs.pt/upload/member.id/files/i006254.pdf. Conclusion: Hypertension undoubtedly requires continuous attention given the consequences for the mother, but also for the fetus. A detection of a woman with hypertensive pathology should be referred to High Obstetric Risk Consultation.
Introduction: Hypertension is one of the most common pathologies in pregnancy, with repercussions for both maternal health and fetal development. With an approximate prevalence of 10% in all pregnancies, it becomes imperative to have a prior diagnosis as well efficient therapeutic procedures. Defined by the American College of Obstetricians and Gynecologists (ACOG) as systolic blood pressure> 140 mmHg and / or diastolic> 90 mmHg, it can be divided into 4 main groups: preeclampsia, gestational hypertension, chronic hypertension and hypertension with overlapping eclampsia. Distinct and until then, scarcely known, respiratory fistulae such as decreased maternal-fetal flow, immunogenetic aspects, a probable presence of the gene for the production of nitric oxide and HLA, endothelial system and consequently placental maladaptation will be associated with this intercurrence in the pregnancy. The therapeutic measures should be employed according to the drug efficacy with the least achievable consequences for the fetus. It is also known that although some drugs can effectively lower blood pressure, a single effective solution in hypertensive syndromes such as preeclampsia and pregnancy-induced hypertension is childbirth. Objectives: To investigate and critically analyze a literature on several physiopathological mechanisms that have been studied as causes that trigger hypertension during pregnancy, as well as therapeutic specialties associated with this pathology, including the benefits and risks of certain drugs. It is also intended to emphasize the exercise of the health professional as a fundamental impeller in the counseling of adoption of healthy lifestyles, with a focus on the prevention of hypertension. Methods: For this review, a large bibliographical research was carried out which sources were based mainly on PubMED, ScienceDirect, as guidelines of the Portuguese Society of Hypertension in www.sphta.orgh.pt and as norms of the General Directorate of Health at https: / /www.dgs.pt/upload/member.id/files/i006254.pdf. Conclusion: Hypertension undoubtedly requires continuous attention given the consequences for the mother, but also for the fetus. A detection of a woman with hypertensive pathology should be referred to High Obstetric Risk Consultation.
Description
Keywords
Anti-Hipertensores Fisiopatologia Gravidez Hipertensão Pré-Eclâmpsia