Pre-eclampsia and maternal mortality: relationship between risk factors, early diagnosis and prevention

Abstract

Objective: To discuss hypertensive diseases during pregnancy and discuss their risk factors, diagnosis and prevention.  Bibliographic review: Maternal death is characterized by death from complications generated or aggravated by pregnancy during the period that includes pregnancy, childbirth and puerperium.  Among the causes of these complications, gestational hypertension is among the main ones, even though it is potentially preventable.  Studies show a significant association of low socioeconomic status, maternal age, early gestational age and previous chronic diseases with unfavorable maternal outcomes. Although, there are no well-defined protective measures, research indicates that prevention can be provided by the use of aspirin, calcium supplementation and continuous monitoring of pregnancy. When not avoided, hypertensive disorders require an early diagnosis, which can be done through specific tests, such as the measurement of metalloprotease ADAM12-S, and allows obstetric interventions to be taken to avoid severe maternal conditions.  Ideally, these interventions should be taken in the context of an empowered health system, which is often not guaranteed. Final considerations: It was found that there are multiple indicators to establish risk factors, early diagnosis and prevention.  However, further studies should be encouraged aiming at the creation of consolidated protocols in the management of hypertensive pregnant women.