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Preeclampsia si eclampsia

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In jur de 5-8% dintre femei sunt afectate de o complicatie in timpul sarcinii, numita preeclampsie sau toxemie gravidica. Aceasta apare dupa a 20-a saptamana si se caracterizeaza printr-o hipertensiune arteriala. Afectiunea poate cauza numeroase probleme atat mamei, cat si copilului - printre care si eclampsia, o boala periculoasa datorita simptomelor severe.

Care e diferenta dintre eclampsie si preeclampsie?

Preeclampsia este o complicatie ce apare adesea in cazul femeilor insarcinate din cauza hipertensiunii arteriale. Acesta apare de obicei in jurul saptamanii a 20-a de sarcina fiind marcata de cresterea tensiunii sau de cresterea nivelului de proteine din urina in urma unor probleme aparute la rinichi. Complicatia ce se manifesta prin preeclampsie poate afecta organismul mamei, indeosebi placenta fiind marcata prin ficat, rinichi, ochi si creierul mamei. Fatul poate fi deopotriva afectat prin o nastere prematura, greutate mica la nastere sau chiar decesul fatului in cazurile cele mai sumbre.

Eclampsia este de asemenea o complicatie ce apare in timpul sarcinii, insa aceasta este mai severa decat preeclampsia si poate cauza atac de cord si intrarea in coma a mamei. Netratata imediat eclampsia poate fi fatala. Din nefericire eclampsia este cea de-a doua cauza a mortii materne.

O crestere a hipertensiunii nu indica in mod neaparat existenta sau riscul unei asemenea complicatii, insa preventia este cea mai buna.

 

Factori de risc ai preeclampsiei

Din nefericire nu s-a stabilit o cauza exacta a preeclampsiei insa exista anumiti factori care pot fi considerati drept factori de risc. Printre acesti factori se numara:

  • femeile care sunt la prima sarcina, dupa 35 de ani
  • sarcina multipla
  • diabet preexistent
  • obezitate
  • gravida mai tanara de 20 de ani sau mai in varsta de 40
  • afectiuni ale rinichilor, preexistente
  • preeclampsie dintr-o sarcina anterioara
  • hipertensiune arteriala cronica

 

Simptomele preeclampsiei

Adesea femeile insarcinate nu prezinta niciunul din aceste semnale de risc. Uneori severitatea preeclampsiei este relationata cu tensiunea arteriala, insa in cazul in care simptologia comuna nu e prezenta acorda atentie la urmatorii factori:

  • umflarea mainilor si a picioarelor (umflarea picioarelor este un simptom de sarcina, desi acesta luat individual nu este relevant)
  • dureri persistente de cap
  • vedere incetosata
  • sensibilitate la lumina
  • edeme si crestere in greutate cu peste 1 kg saptamanal

 

preeclampsia

 

Puteti observa ca printre simptomele mentionate mai sus nu toate sunt un unic indicator al preeclampsiei, acestea putand fi intalnite si in cazul unei sarcini sanatoasa. Se recomandat astfel vizitele regulate la ginecolog pentru teste de urina si masurare a tensiunii arteriale. Pentru a indentifica la timp preeclampsia nu exista un anumit test standard, in cazul in care medicul sau viitoarea mama considera necesara va avea loc o examinare a urinei, a sangelui si monitorizarea tensiunii arteriale pentru a evita complicatii in timpul sarcinii.

Am stabilit ca in mod frecvent medicii leaga cresterea tensiunii arteriale cu preeclampsia, insa chiar si aceasta creste este legata de valorile normale ale tensiunii arteriale. In anumite cazuri, tensiunea arteriala normala se claseaza la 130/80 in timp ce pentru alte femei o valoarea mai mare poate fi un indicator.

 

Tratamentul preeclampsiei

Tratamentul unei hipertensiuni arteriale gravidice moderate cuprinde:

  • incetarea activitatilor
  • odihna completa
  • medicatie hipertensiva
  • supraveghere stricta: greutate, diureza, tensiune arteriala, nivelul proteinelor din urina, uricemie, creatimie
  • supravegherea vitalitatii fatului prin monitorizare fetala permanenta.

 

In cazul crizelor de eclampsie acestea se fac in mediu spitalicesc si cuprind administrarea de anticonvulsive. In general pacienta se vindeca si nu exista recidive, in ciuda anumitor complicatii pe termen lung ce ar putea sa apara.







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