PRÉ-ECLÂMPSIA E HIPERTENSÃO GESTACIONAL: IMPLICAÇÕES MATERNO-FETAIS E AVANÇOS NO MANEJO CLÍNICO

Abstract

INTRODUCTION: Pre-eclampsia (PE) and gestational hypertension (HG) are hypertensive disorders of pregnancy that represent important causes of maternal and fetal morbidity and mortality, especially in developing countries. PE is characterized by hypertension and proteinuria after the 20th week of pregnancy, while HG refers to hypertension diagnosed in pregnancy without proteinuria. Both conditions are responsible for serious complications such as intrauterine growth restriction (IUGR), premature birth and eclampsia, as well as increasing maternal cardiovascular risk in the long term. Clinical management has evolved significantly in recent decades, with advances in both early detection and treatment aimed at minimizing adverse outcomes. OBJECTIVE: The aim of this review is to explore the maternal-fetal implications associated with pre-eclampsia and gestational hypertension, as well as to discuss the most recent advances in the clinical management of these conditions. The research aims to provide a comprehensive overview of the pathophysiological mechanisms involved, the risk factors and the therapeutic interventions that have shown promising results in reducing complications. METHODOLOGY: Systematic literature review in which journals published between 2010 and 2024 were selected using searches in the main databases, Scielo, BVS, Google Scholar, Mendeley and PubMed. RESULTS:  Pre-eclampsia and gestational hypertension are associated with a significant increase in complications for both mother and fetus. Among the main maternal outcomes are eclampsia, kidney failure, HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count), as well as an increased risk of developing chronic cardiovascular diseases. In the fetus, complications include intrauterine growth restriction (IUGR), premature birth and neonatal mortality. Advances in clinical management, such as the use of low-dose aspirin to prevent PE in high-risk patients, as well as new approaches to monitoring placental function and the use of biochemical markers, have proved effective in improving outcomes. CONCLUSION: Pre-eclampsia and gestational hypertension remain major challenges in obstetric medicine, with serious implications for maternal and fetal health. However, advances in the early identification of risk factors and the development of promising preventive and therapeutic interventions have contributed to reducing the morbidity and mortality associated with these conditions.