Análise das alterações anatomopatológicas macroscópicas placentárias das doenças hipertensivas específicas da gestação
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Data
2011-03-25
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Universidade Federal de Goiás
Resumo
The etiopathogenesis of gestational hypertension has been widely studied, but it is
not very well established in medical literature. Due to the low
uteroplacental perfusion, light to moderate hypertension in the third trimester of
pregnancy may be an adaptive response of the maternal organism in order to keep
adequate blood flow in the fetal compartment. This paper aims to identify the
socioeconomic factors of the parturients with gestational hypertension associated
with the maternal and fetal conditions, as well as the gross placental pathological
changes. The study was conducted in a federal public maternity hospital in Goiânia,
in the state of Goiás, between March 2009 and February 2010. Placental and clinical
data of 61 parturients with and without diagnosis (control group) of gestational
hypertension were collected. 18 placentas of parturients with chronic hypertension
(CH) (29.5%), 11 with gestational hypertension (HGE) (18%), 3 with eclampsia
(4.9%), 28 of pre-eclampsia (PE) (45.9%), and 1 diagnosed with HELLP Syndrome
(1.63%). The main placental changes found were: hematomas, presence of fibrin,
fibrosis, infarction, calcifilaxis and areas of detachment. There was statistically
significant difference concerning the occurrence of infarction on the maternal side of
women with eclampsia (p = 0.047). The deposit of fibrin on the maternal side of the
placentas of women with gestational hypertension was significantly larger than that of
the women in the control group (p = 0.008). Calcifilaxis was larger on the maternal
side of the placentas of women in the control group when compared to the group with
gestational hypertension (p = 0.056). A statistically significant result was obtained
when analyzing the presence of fibrin in the groups of PE and control (p = 0.024).
There was a significantly larger deposit of fibrin on the fetal side of the placentas of
women with HGE than of those in the control group (p = 0.048). Hypertensive
disorders of pregnancy are studied as a worldwide problem of public health and rank
third among the causes of maternal death in the world and first in Brazil. This is the
reason why this study was carried out taking into consideration the need of an
increasingly humanized obstetric care focused on the main placental changes and
their impact on maternal and fetal vitality in the puerperium.
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Citação
XAVIER, Raphaela Maioni. Analysis of the gross placental pathological changes in the hypertensive disorders of pregnancy. 2011. 201 f. Dissertação (Mestrado em Cuidado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2011.