CLINICAL AND ANAMNESTIC RISK FACTORS FOR SEVERE PREECLAMPSIA: A LITERATURE REVIEW
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Abstract
Hypertensive disorders hold the leading position among causes of maternal mortality. Severe preeclampsia is associated with a high probability of developing HELLP syndrome, eclampsia, multiple organ failure, as well as preterm birth and neonatal death.
Objective – to analyze data on clinical and anamnestic risk factors for severe preeclampsia over the past 5 years.
Materials and Methods. The PRISMA 2020 protocol was used. The review includes data from 38 studies.
Results. History-taking is a simple and accessible method for identifying women at risk for preeclampsia. Traditional risk factors have high sensitivity; however, the use of clinical risk factors alone is significantly inferior to combined models in predicting the severe phenotype. The widespread use of genetic and epigenetic predictors is currently limited by the lack of large-scale studies and the heterogeneity of the data obtained. The introduction of markers of abnormal placentation and genetic studies into clinical practice will not only allow for the early identification of the high-risk group for developing severe preeclampsia but also create a foundation for the development of pathogenetically based therapeutic approaches.
Conclusions. Early diagnosis of the severe phenotype based on risk factors is challenging. Studies demonstrate the key role of angiogenic imbalance in predicting the early-onset subtype of preeclampsia and establish the link with long-term cardiovascular consequences. Epigenetic markers can identify specific placental patterns associated with an aggressive course even before the manifestation of clinical symptoms.
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The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
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