| Abstract | Iako su provedena brojna istraživanja, etiologija preeklampsije i dalje ostaje nerazjašnjena. Čimbenike koje trenutno smatramo najvažnijima u mehanizmu nastanka PE su nenormalna placentacija, kardiovaskularne promjene te genetski i okolišni čimbenici. Kombinacije testova pokazale su se do sada najpouzdanijim metodama predikcije preeklampsije. Mjerenje protoka krvi uterine arterije ultrazvučnim dopplerom u kombinaciji sa dva ili više biljega (sFlt1/PIGF, PAPP-A) pokazalo je zadovoljavajuću specifičnost i osjetljivost. Uz ove dijagnostičke pretrage potrebno je uzeti dobru anamnezu, jer se smatra da samim uzimanjem anamneze možemo procijeniti rizik nastanka PE u oko 30% slučajeva. Riziko-faktori koji su nam bitni u anamnezi su: nuliparitet, povišen indeks tjelesne težine, crna rasa, PE u obitelji, neobjašnjeni zastoj u rastu, trudnica koja nema dovoljan prirast na masi s obzirom na tjedan trudnoće u kojem je, fetalne smrti u prijašnjim trudnoćama, abrupcija placente, genske bolesti roditelja, hidatiformna mola, višeplodne trudnoće, žene starije od 40, odnosno mlađe od 18 godina, te komorbiditeti (kronična hipertenzija, vaskularne bolesti, dijabetes i bolesti bubrega). Osim navedenih metoda znanstvenici su se okrenuli genskim istraživanjima i proteomici, međutim broj takvih radova je za sada minimalan i potrebno je provesti daljnja istraživanja koja bi nam mogla ponuditi novi model predikcije preeklampsije.
Prevencija preeklampsije nakon 30 godina istraživanja i dalje daje nedovoljne rezultate. Preporuka prevencije PE mnogih liječničkih udruženja temelji se na uzimanju niskih doza aspirina. Primjena kalcija opravdana je kod trudnica koje općenito imaju manjak unosa ovog elementa, ali se nije pokazala opravdanom za opću prevenciju preeklampsije. Antioksidansi, antiagregacijska terapija i primjena vitamina D se nisu pokazali statistički značajnim. |
| Abstract (english) | While there have been numerous studies on PE, the etiology of the disease remains unclear. The factors that are currently considered to be the most important in the pathogenesis of PE are abnormal placentation, cardiovascular changes, and genetic and environmental factors. So far, the combination of tests has proved to be one of the most reliable methods of predicting. Measurement of blood flow of the uterine artery with a Doppler ultrasound in combination with two or more markers (sFlt1 / PIGF, PAPP-A) has shown a satisfactory specificity and sensitivity. In addition to these diagnostic tests it is necessary to obtain a good medical history because it is considered that by the sole act of obtaining a patient's medical history it is possible to estimate the risks of the development of PE in 30% of cases. Risk-factors that are important in medical history of a patient are: nulliparity, increased bodymass index, black race, the family history of PE, unexplained delay in growth, pregnant woman who does not have a sufficient increase in weight considering the stage of the pregnancy , fetal death in the previous pregnancies, placenta abruption, genetic disease of parents, hydatid mole, multiple pregnancy, women older than 40 or younger than 18 years old, and comorbidities (chronic hypertension, vascular disease, diabetes and kidney disease). In addition to the above-mentioned methods, scientists have turned to genetic research and proteomics, but the number of such operations is now minimal and it is necessary to conduct further research which may be able to offer a new model for prediction of PE. The prevention of PE after 30 years of research still provides insufficient results. Recommendation for the prevention of PE by many medical associations is based on taking low-dose aspirin. The use of calcium is justified in pregnant women who are in general deficient in this element, but it has not been proven sufficient for general prevention of PE. Antioxidants, antiplatelet therapy and administration of vitamin D have not been proven to be of any statistical significance. |
