Preeclampsia: what is the clinical controversy

doi:10.3877/cma.j.issn.2095-3259.2021.04.001

Abstract

Abstract:

Preeclampsia is a sever common complication of pregnancy, and is responsible for about 70000 maternal deaths and 500000 neonatal deaths. Therefore, preeclampsia always captured eyes of obstetricians. Due to the limitations of regional, scientific research level and research progress, the published guidelines are often conflicted with recent studies. This article discusses three of the most controversial issues concerning the diagnosis and prevention of preeclampsia in the current clinical guidelines, which included the threshold of blood pressure, the relationship between degree of proteinuria and prognosis of preeclampsia, and the preventive treatment with aspirin.

Key words: Preeclampsia, Blood pressure, Proteinuria, Aspirin

Huili Zhang, Dunjin Chen. Preeclampsia: what is the clinical controversy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2021, 10(04): 193-196.

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References 22

[1]	Rana S, Lemoine E, Granger JP, et al. Preeclampsia: Pathophysiology, Challenges, and Perspectives [J]. Circ Res, 2019，124(7):1094-1112.
[2]	Pierik E, Prins JR, van Goor H, et al. Dysregulation of Complement Activation and Placental Dysfunction: A Potential Target to Treat Preeclampsia？[J]. Front Immunol, 2020, 10:1-14.
[3]	Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [J]. Hypertension, 2018，71(6): e13-e115.
[4]	Sisti G, Colombi I. New blood pressure cut off for preeclampsia definition: 130/80 mmHg [J]. Eur J Obstet Gynecol Reprod Biol, 2019, 240: 322-324.
[5]	中华医学会妇产科学分会妊娠期高血压疾病学组. 妊娠高血压期疾病诊治指南(2020) [J]. 中华妇产科杂志，2020, 55(4): 227-238.
[6]	American College of Obetricians and Gynecologists′ Committee. ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia Obstet Gynecol [J]. Obstet Gynecol，2019，133(1):e1-e25.
[7]	Sisti G, Williams B. Body of Evidence in Favor of Adopting 130/80 mmHg as New Blood Pressure Cut-Off for All the Hypertensive Disorders of Pregnancy [J]. Medicina (Kaunas), 2019, 55(10):1-6.
[8]	Hu J, Li Y, Zhang B, et al. Impact of the 2017 ACC/AHA Guideline for High Blood Pressure on Evaluating Gestational Hypertension-Associated Risks for Newborns and Mothers [J]. Circ Res, 2019, 125(2):184-194.
[9]	He D, Wu S, Zhao H, et al. High normal blood pressure in early pregnancy also contribute to early onset preeclampsia and severe preeclampsia [J]. Clin Exp Hypertens, 2018, 40(6):539-546.
[10]	Fishel Bartal M, Lindheimer MD, Sibai BM. Proteinuria during pregnancy: definition, pathophysiology, methodology, and clinical significance [J]. Am J Obstet Gynecol, 2020:1-16.
[11]	Phillips JK, McBride CA, Hale SA, et al. Examination of Prepregnancy and Pregnancy Urinary Protein Levels in Healthy Nulliparous Women [J]. Reprod Sci, 2017, 24(3): 407-412.
[12]	Kattah A, Milic N, White W, et al. Spot urine protein measurements in normotensive pregnancies, pregnancies with isolated proteinuria and preeclampsia [J]. Am J Physiol Regul Integr Comp Physiol, 2017，313(4):R418-R424.
[13]	Folk DM. Hypertensive Disorders of Pregnancy: Overview and Current Recommendations [J]. J Midwifery Womens Health, 2018, 63(3):289-300.
[14]	Li B, Lin L, Yang H, et al. The value of the 24-h proteinuria in evaluating the severity of preeclampsia and predicting its adverse maternal outcomes [J]. Hypertens Pregnancy, 2018, 37(3):118-125.
[15]	Kim MJ, Kim YN, Jung EJ, et al. Is massive proteinuria associated with maternal and fetal morbidities in preeclampsia？[J]. Obstet Gynecol Sci, 2017，60(3):260-265.
[16]	Meher S, Duley L, Hunter K, et al. Antiplatelet therapy before or after 16 weeks′ gestation for preventing preeclampsia: an individual participant data meta-analysis [J]. Am J Obstet Gynecol, 2017, 216(2):121-128.e2.
[17]	Finnegan C, Breathnach FM. The Role of Aspirin for Preeclampsia Prevention in Women with Diabetes [J]. Curr Diab Rep, 2020, 20(12):1-6.
[18]	Ma′ayeh M, Costantine MM. Prevention of preeclampsia [J]. Semin Fetal Neonatal Med, 2020, 25(5):1-12.
[19]	Sisti G. Maternal Outcomes Associated With Lower Range Stage 1 Hypertension [J]. Obstet Gynecol, 2019, 133(1):190.
[20]	Gu W, Lin J, Hou YY, et al. Effects of low-dose aspirin on the prevention of preeclampsia and pregnancy outcomes: A randomized controlled trial from Shanghai, China [J]. Eur J Obstet Gynecol Reprod Biol, 2020, 248:156-163.
[21]	Roberge S, Bujold E, Nicolaides KH. Aspirin for the prevention of preterm and term preeclampsia: systematic review and metaanalysis [J]. Am J Obstet Gynecol, 2018, 218(3):287-293.e1.
[22]	Tapp S, Guerby P, Girard M, et al. A Pilot Randomized Trial Comparing the Effects of 80 versus 160 mg of Aspirin on Midtrimester Uterine Artery Pulsatility Index in Women with a History of Preeclampsia[J]. J Obstet Gynaecol Can, 2020，42(12):1498-1504.

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