Preeclampsia-Spectrum hypertensive disorders of pregnancy: therapeutic approaches and prognosis

Objective. Preeclampsia is a disease exclusive to pregnancy and the immediate postpartum period, occurring in 8% of pregnancies worldwide, associated with considerable ma­ternal and foetal morbidity. The objective is to review preg­nancy hypertension clinical treatments guidelines at UHOG “Mbretëresha Geraldinë”.
Materials and Methods. Our review takes into consideration deliveries from 2015-2021 at UHOG. There were in total 43,820 women out of whom 1,071 were diagnosed with preeclamp­sia, from which 675 had taken aspirin and a low dose of cal­cium since the 16th weeks, because they had PE in their past pregnancies.
838 (78.2%). of them delivered with caesarean section and around 21.8% with natural delivery.
Results. Preeclampsia prevention with aspirin and low calci­um intake before 16 weeks among patients with previous PE seem to be beneficial for prevention of severe PE.
Recent data about heparin with low molecular weight are still conflicting.
Antihypertensive treatment: severe hypertension, most com­monly done with intravenous labetalol and oral nifedipine.
Non severe hypertension with oral labetalol (in particular), methyldopa, or nifedipine.
Eclampsia treatment and prevention done with MgSO4. It is also used among women with severe preeclampsia. MgSO4 compared with placebo more than halved the risk of eclampsia.
MgSO4 is recommended for imminent preterm birth like a neuroprotection.
The likelihood of caesarean delivery at less than 28 weeks of gestation could be as high as 97%, and at 28+32 weeks of ges­tation as high as 65%.
Conclusions. Prevention and treatment of preeclampsia are crucial in saving lives and the following were consistently rec­ommended.