Rastreio de pré-eclâmpsia no primeiro trimestre
DOI:
https://doi.org/10.33448/rsd-v12i1.39242Palavras-chave:
Pré-eclâmpsia; Primeiro trimestre da gravidez; Gravidez de alto risco.Resumo
O presente estudo teve como objetivo discorrer sobre o rastreio de pré-eclâmpsia no primeiro trimestre de gestação. A pré-eclâmpsia é considerada uma das principais causas de morbimortalidade materna e fetal. Devido a isto, faz-se importante identificar gestantes em risco de desenvolver pré-eclâmpsia durante o primeiro trimestre da gravidez, permitindo assim uma intervenção terapêutica oportuna. Organizações profissionais, como o American College of Obstetricians and Gynecologists e o National Institute for Health and Care Excellence, propuseram a triagem para pré-eclâmpsia com base em fatores de risco materno. No entanto, poucos exames laboratoriais possuem alta especificidade e sensibilidade para identificar tal patologia precocemente. Vale ressaltar que o modelo de previsão do primeiro trimestre da Fetal Medicine Foundation, que consiste em uma combinação de fatores maternos e medições da pressão arterial média, índice de pulsatilidade da artéria uterina e fator de crescimento placentário sérico, passou por validação interna e externa bem-sucedida, tal teste de triagem apresenta-se superior ao método tradicional (apenas por fatores de risco maternos). Quando identificadas, as gestantes com alto risco para desenvolver pré-eclâmpsia devem fazer o uso de aspirina de baixa dose iniciada antes das 16 semanas de gestação, assim como o uso de cálcio em gestantes com baixa ingesta visando a redução na taxa de pré-eclâmpsia pré-termo. Com isso, objetivando um desempenho ideal na triagem devem ser estabelecidos protocolos padronizados para medições de biomarcadores e avaliação regular da qualidade dos biomarcadores.
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