Pre-eclampsia

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Pre-eclampsia bu mgbe enwere otutu Ori na n'ime ahu di iche iche nke ime na ebute, nke eji obara ngbanielu na otutu protein na mmariri nwere mara. Ona ebido n'izuka iriabuo nwaanyi jiri do ime. N'otutu oge mgbe odi njo ana enwe red blood cell breakdown, blood platelet ndi ntakiri liver na anaghi Aru ofuma, kidney nwere nsogbu, ahu iza aza, ikughi ime ofuma maobu ahughi uxo ofuma. [1] [2][3]. [4][5] [6][7][5].[4][4]

Ihe ize ndụ maka pre-eclampsia gụnyere oke ibu, ọbara mgbali elu, ịka nká, na Ọrịa shuga.[4][8] Ọ na-adịkarị na ime ime mbụ nke nwanyị na ma ọ bụrụ na ọ na-amụ ejima.[1] Usoro ndị dị n'okpuru ya dị mgbagwoju anya ma na-agụnye mmepụta ọbara na-adịghị mma na placenta n'etiti ihe ndị ọzọ.[1] A na-achọpụta ọtụtụ ndị ọrịa tupu a mụọ nwa, a pụkwara ịhazi ha dabere na izu ime mgbe a mụọ.[6] Dị ka ọ na-adịkarị, pre-eclampsia na-aga n'ihu n'ime oge mgbe a mụsịrị ya, nke a maara mgbe ahụ dị ka postpartum pre-eclasmpsia. [9][10] N'ụzọ na-adịghị ahụkebe, pre-eclampsia nwere ike ịmalite n'oge mgbe a mụsịrị nwa. [5] Ọ bụ ezie na n'akụkọ ihe mere eme, a chọrọ ma ọbara mgbali elu na protein dị na mamịrị iji mee nchọpụta ahụ, nkọwa ụfọdụ gụnyekwara ndị nwere ọbara mgbali ala na nsogbu ọ bụla metụtara ya. [6][3] A na-akọwa ọbara mgbali elu dị ka onye dị elu mgbe ọ karịrị 140 mmHg systolic ma ọ bụ 90 mmHg diastolic n'oge abụọ dị iche iche, ihe karịrị awa anọ dị iche iche n'ime nwanyị mgbe izu iri abụọ nke ime gasịrị. [6]   A na-enyocha pre-eclampsia mgbe niile n'oge Nlekọta tupu amụọ nwa. [11][12]

Ntuziaka maka mgbochi gụnyere: aspirin na ndị nọ n'ihe ize ndụ dị elu, Mgbakwunye calcium na mpaghara ndị na-eri obere, na ọgwụgwọ nke ọbara mgbali elu tupu ọgwụ.[8][13] N'ime ndị nwere pre-eclampsia, ịmụ nwa na Placenta bụ ọgwụgwọ dị irè [1] mana mgbake zuru oke nwere ike iwe ọtụtụ ụbọchị ma ọ bụ izu. [9] Ebe a na-atụ aro ịmụ nwa na-adabere n'otú pre-eclampsia siri sie ike na ogologo oge nwanyị dị ime.[1] Enwere ike iji ọgwụ mgbochi ọbara, dị ka labetalol na methyldopa, mee ka ọnọdụ nne dị mma tupu ọ mụọ nwa.[14] Enwere ike iji Magnesium sulfate gbochie eclampsia na ndị nwere ọrịa siri ike.[1] A chọpụtabeghị na ezumike n'àkwà na iri nnu bara uru maka ọgwụgwọ ma ọ bụ mgbochi. [1][8][./Pre-eclampsia#cite_note-ACOG2013-3 [5]]

Ihe ịrịba ama na mgbaàmà[dezie | dezie ebe o si]

Edema (karịsịa n'aka na ihu) ka a na-ewere na mbụ dị ka ihe ịrịba ama dị mkpa maka nchọpụta nke pre-eclampsia. Otú ọ dị, n'ihi na ọzịza bụ ihe a na-ahụkarị n'ime ime, uru ya dị ka ihe dị iche na pre-eclampsia adịghị elu. Pitting edema (ọzịza a na-adịghị ahụkebe, ọkachasị nke aka, ụkwụ, ma ọ bụ ihu, nke a na-ahụkarị site na ịhapụ indentation mgbe a na-agbanye ya) nwere ike ịdị ịrịba ama, a ga-ekwukwa ya na onye na-ahụ maka ahụike.

Ọzọkwa, enwere ike ịkọwa ihe mgbaàmà dị ka ihe mgbu epigastric dị ka obi ọkụ. Ihe ndị a na-ahụkarị nke pre-eclampsia nke a na-enyocha n'oge nleta tupu amụọ gụnyere ọbara mgbali elu na protein karịrị akarị na mamịrị. Tụkwasị na nke a, ụfọdụ ụmụ nwanyị nwere ike inwe isi ọwụwa dị egwu dị ka ihe ịrịba ama nke pre-eclampsia.[15] N'ozuzu, ọ dịghị ihe ịrịba ama ọ bụla nke pre-eclampsia bụ ihe a kapịrị ọnụ, ọbụnakwa convulsions n'ime ime nwere ike ịnwe ihe ndị ọzọ na-akpata ya karịa eclampsia n'omume ọgbara ọhụrụ.[16] Nnyocha na-adabere n'ịchọta nkwekọrịta nke ọtụtụ atụmatụ pre-eclamptic, ihe akaebe ikpeazụ bụ nzaghachi ha n'ime ụbọchị na izu mgbe a mụsịrị ha.[9]

Ihe Ndị Na-akpata ya[dezie | dezie ebe o si]

Enweghi nsogbu amaboro Anya dika ihe na ebute Oria, mana enwere ihe nwere Ike ipalite ya. Ufodu gunyere:[4][11]

  • Placentation na-adịghị mma (ọdịdị na mmepe nke placenta)
  • Ihe ndị na-akpata ahụike
  • Ọrịa nne tupu ma ọ bụ nke dị ugbu a - a na-ahụ pre-eclampsia karịa na ndị nwere ọbara mgbali elu, oke ibu, ma ọ bụ ọrịa antiphospholipid antibody syndrome ma ọ bụ ndị nwere akụkọ ihe mere eme nke pre-eclasm
  • Ihe ndị na-eri nri, dịka mgbakwunye calcium n'ebe nri calcium dị ala egosila na ọ na-ebelata ihe ize ndụ nke pre-eclampsia [8]
  • Ihe ndị metụtara gburugburu ebe obibi, dịka mmetọ ikuku [17]

Ndị nwere ọbara mgbali elu ogologo oge nwere ihe ize ndụ okpukpu 7 ruo 8 karịa ndị na-enweghị.[18]

N'ihe gbasara ahụike, nchọpụta ejikọtala pre-eclampsia na mgbanwe ndị na-esonụ: mgbanwe na mmekọrịta dị n'etiti mmeghachi omume nke nne na placenta, mmerụ ahụ nke placenta, mmebi nke mkpụrụ ndụ endothelial, mgbanwe nke mmeghachi nke vascular, nrụgide oxidative, enweghị nkwụsi ike n'etiti ihe ndị na-arụ ọrụ, mbelata nke intravascular, na disseminated intravasculation.[11][19]

Ọ bụ ezie na kpọmkwem ihe kpatara pre-eclampsia ka bụ ihe a na-ejighị n'aka, enwere ihe akaebe siri ike na isi ihe na-eme ka nwanyị nwere ike ibute pre-eclempsia bụ placenta a kụrụ n'ụzọ na-adịghị mma.[4][11] Placenta a a na-etinye n'ụzọ na-adịghị mma nwere ike ịkpata infusion dị njọ nke akpa nwa na placental, na-emepụta ọnọdụ hypoxia na nrụgide oxidative na-abawanye na ntọhapụ nke protein anti-angiogenic yana ndị na-eme ka ọ na-afụ ụfụ n'ime plasma nne.[2] Otu isi nsonaazụ nke usoro ihe omume a bụ dysfunction endothelial.[1] Mmetụta na-adịghị mma nwere ike isi na mmeghachi omume nke usoro ahụike nne na placenta, ọkachasị enweghị nkwenye nke ahụike n'oge ime. Endothelial dysfunction na-akpata ọbara mgbali elu na ọtụtụ mgbaàmà na nsogbu ndị ọzọ metụtara pre-eclampsia.[1] Mgbe pre-eclampsia malitere n'izu ikpeazụ nke ime ime ma ọ bụ n'ime ime ọtụtụ, ihe kpatara ya nwere ike ịbụ n'ọnọdụ ụfọdụ, n'akụkụ ụfọdụ, n"ihi nnukwu placenta na-eto karịa ikike nke akpa nwa, n'ikpeazụ na-eduga na mgbaàmà nke pre-eclasmpsia.[20]

chromosome 19 microRNA cluster (C19MC) na-emebi mwakpo nke mkpụrụ ndụ trophoblast extravillus na Akwara na-agba gburugburu, na-akpata nguzogide dị elu, obere ọbara, na obere ihe na-edozi ahụ na nwa e bu n'afọ. [21] [22][23]

Ihe ndị metụtara mkpụrụ ndụ ihe nketa[dezie | dezie ebe o si]

N'agbanyeghị enweghị ihe ọmụma banyere usoro ụfọdụ na-akpata pre-eclampsia, enwere ihe akaebe siri ike iji tụọ aro na ọ na-esite na gburugburu ebe obibi na ihe nketa. Nnyocha e mere n'afọ 2005 gosiri na ụmụ nwanyị nwere onye ikwu mbụ nke nwere ọmụmụ pre-eclamptic nwere ohere okpukpu abụọ karịa nke ahụ n'onwe ha. Ọzọkwa, ndị ikom nwere njikọ na onye nwere nsogbu ịmụ nwa nwere ohere dị ukwuu nke ịmụ ime tupu eclamptic.[24] Ụmụ ọhụrụ nwere nsogbu pre-eclampsia nwere ohere dị elu nke nsogbu ime ime mgbe e mesịrị gụnyere mgbochi uto, ịmụ nwa n'oge, na ịmụ nwa nwụrụ anwụ.[25]

A na-eche na mmalite nke pre-eclampsia sitere na ọtụtụ mmekọrịta dị mgbagwoju anya n'etiti mkpụrụ ndụ ihe nketa na ihe ndị metụtara gburugburu ebe obibi. Nghọta anyị ugbu a banyere ihe nketa a na-eketa eketa na-agụnye enweghị nkwekọ nke ihe ndị na-akpata angiogenic na placenta.[26] Angiogenesis na-agụnye uto nke akwara ọbara ọhụrụ site na akwara ndị dị ugbu a, na enweghị nkwekọ n'oge ime nwere ike imetụta vascularization, uto, na ọrụ nke nwa e bu n'afọ. A na-eche na ngosipụta na-adịghị mma nke ihe ndị a na-achịkwa site na ọtụtụ loci na chromosomes dị iche iche.[27][25][28] Nnyocha banyere isiokwu a enweela oke n'ihi ọdịdị dị iche iche nke ọrịa ahụ. Genotypes nke nne, nna, na nwa e bu n'afọ niile na-arụ ọrụ yana ihe mgbagwoju anya epigenetic dị ka ma ndị nne na nna na-ese siga, afọ nne, mmekọahụ, na oke ibu.[1] Ka ọ dị ugbu a, enwere obere nghọta n'azụ usoro mmekọrịta ndị a. N'ihi ọdịdị polygenic nke pre-eclampsia, ọtụtụ n'ime ọmụmụ ndị e mere ruo ugbu a na isiokwu ahụ ejirila ọmụmụ njikọ nke genome.[24]

  1. ↑ 1.0 1.1 (2012) "Preeclampsia 2012". Journal of Pregnancy 2012: 586578. DOI:10.1155/2012/586578. PMID 22848831.  Kpọpụta njehie: Invalid <ref> tag; name "Ei2012" defined multiple times with different content
  2. ↑ (2013) Hypertension in pregnancy. ACOG. ISBN 978-1-934984-28-4. Retrieved on 2016-11-17. 
  3. ↑ 3.0 3.1 (2014) "Preeclampsia: an update". Acta Anaesthesiologica Belgica 65 (4): 137–149. PMID 25622379.  Kpọpụta njehie: Invalid <ref> tag; name ":2" defined multiple times with different content
  4. ↑ 4.0 4.1 4.2 4.3 4.4 (February 2014) "A brief overview of preeclampsia". Journal of Clinical Medicine Research 6 (1): 1–7. DOI:10.4021/jocmr1682w. PMID 24400024.  Kpọpụta njehie: Invalid <ref> tag; name "Al2014" defined multiple times with different content
  5. ↑ 5.0 5.1 5.2 (November 2013) "Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy". Obstetrics and Gynecology 122 (5): 1122–1131. DOI:10.1097/01.AOG.0000437382.03963.88. PMID 24150027. Retrieved on 2015-02-17.  Kpọpụta njehie: Invalid <ref> tag; name "ACOG2013" defined multiple times with different content
  6. ↑ 6.0 6.1 (May 2022) "Preeclampsia". The New England Journal of Medicine 386 (19): 1817–1832. DOI:10.1056/NEJMra2109523. PMID 35544388.  Kpọpụta njehie: Invalid <ref> tag; name ":1" defined multiple times with different content
  7. ↑ (October 2019) "Role of B1 and B2 lymphocytes in placental ischemia-induced hypertension". American Journal of Physiology. Heart and Circulatory Physiology 317 (4): H732–H742. DOI:10.1152/ajpheart.00132.2019. PMID 31397167. 
  8. ↑ 8.0 8.1 8.2 8.3 (2011) WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia.. World Health Organization. ISBN 978-92-4-154833-5.  Kpọpụta njehie: Invalid <ref> tag; name "WHO2011" defined multiple times with different content
  9. ↑ 9.0 9.1 9.2 Trusted Health Sites Spread Myths About a Deadly Pregnancy Complication (English). ProPublica (2018-08-14). Archived from the original on 2021-05-15. Retrieved on 2021-05-28. “From the Mayo Clinic to Harvard, sources don't always get the facts right about preeclampsia. Reached by ProPublica, some are making needed corrections.” Kpọpụta njehie: Invalid <ref> tag; name "propublica201808" defined multiple times with different content
  10. ↑ The Last Person You'd Expect to Die in Childbirth (English). ProPublica (2017-05-12). Archived from the original on 2019-06-21. Retrieved on 2021-05-28. “The death of Lauren Bloomstein, a neonatal nurse, in the hospital where she worked illustrates a profound disparity: The health care system focuses on babies but often ignores their mothers.”
  11. ↑ 11.0 11.1 11.2 11.3 (August 2010) "Pre-eclampsia". Lancet 376 (9741): 631–644. DOI:10.1016/S0140-6736(10)60279-6. PMID 20598363.  Kpọpụta njehie: Invalid <ref> tag; name "Lancet2010" defined multiple times with different content
  12. ↑ (April 2017) "Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement". JAMA 317 (16): 1661–1667. DOI:10.1001/jama.2017.3439. PMID 28444286. 
  13. ↑ (May 2014) "Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force". Annals of Internal Medicine 160 (10): 695–703. DOI:10.7326/M13-2844. PMID 24711050. 
  14. ↑ (December 2013) "Severe pre-eclampsia and hypertensive crises". Best Practice & Research. Clinical Obstetrics & Gynaecology 27 (6): 877–884. DOI:10.1016/j.bpobgyn.2013.07.003. PMID 23962474. 
  15. ↑ (January 2001) "The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP)". Hypertension in Pregnancy 20 (1): IX-XIV. DOI:10.3109/10641950109152635. PMID 12044323. 
  16. ↑ Pre-eclampsia. Mayo Clinic. Retrieved on 21 January 2021.
  17. ↑ (November 2009) "Association between local traffic-generated air pollution and preeclampsia and preterm delivery in the south coast air basin of California". Environmental Health Perspectives 117 (11): 1773–1779. DOI:10.1289/ehp.0800334. PMID 20049131. Retrieved on 2009-07-05. 
  18. ↑ (April 2014) "Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis". BMJ 348: g2301. DOI:10.1136/bmj.g2301. PMID 24735917. 
  19. ↑ (2012) "A comprehensive review of hypertension in pregnancy". Journal of Pregnancy 2012: 105918. DOI:10.1155/2012/105918. PMID 22685661. 
  20. ↑ (September 2019) "The two-stage placental model of preeclampsia: An update". Journal of Reproductive Immunology 134-135: 1–10. DOI:10.1016/j.jri.2019.07.004. PMID 31301487. 
  21. ↑ (May 2013) "Human placental microRNAs and preeclampsia". Biology of Reproduction 88 (5): 130. DOI:10.1095/biolreprod.113.107805. PMID 23575145. 
  22. ↑ (February 2014) "Review: placenta-specific microRNAs in exosomes - good things come in nano-packages". Placenta 3 (Suppl): S69–S73. DOI:10.1016/j.placenta.2013.11.002. PMID 24280233. 
  23. ↑ (December 2014) "C19MC microRNAs regulate the migration of human trophoblasts". Endocrinology 155 (12): 4975–4985. DOI:10.1210/en.2014-1501. PMID 25211593. 
  24. ↑ 24.0 24.1 (October 2005) "Recurrence of pre-eclampsia across generations: exploring fetal and maternal genetic components in a population based cohort". BMJ 331 (7521): 877. DOI:10.1136/bmj.38555.462685.8F. PMID 16169871. Skjaerven R, Vatten LJ, Wilcox AJ, Rønning T, Irgens LM, Lie RT (October 2005). "Recurrence of pre-eclampsia across generations: exploring fetal and maternal genetic components in a population based cohort". BMJ. 331 (7521): 877. doi:10.1136/bmj.38555.462685.8F. PMC 1255793. PMID 16169871. Kpọpụta njehie: Invalid <ref> tag; name "Skjaerven R., 2005" defined multiple times with different content
  25. ↑ 25.0 25.1 (August 2018) "Genes for Preeclampsia: An Opportunity for Blood Pressure Genomics". Hypertension 72 (2): 285–286. DOI:10.1161/HYPERTENSIONAHA.118.10840. PMID 29967038. Ehret G (August 2018). "Genes for Preeclampsia: An Opportunity for Blood Pressure Genomics". Hypertension. 72 (2): 285–286. doi:10.1161/HYPERTENSIONAHA.118.10840. PMC 6397719. PMID 29967038. Kpọpụta njehie: Invalid <ref> tag; name "Ehret G., 2018" defined multiple times with different content
  26. ↑ (May 2019) "Pre-eclampsia: pathogenesis, novel diagnostics and therapies". Nature Reviews. Nephrology 15 (5): 275–289. DOI:10.1038/s41581-019-0119-6. PMID 30792480. 
  27. ↑ (August 2017) "Variants in the fetal genome near FLT1 are associated with risk of preeclampsia". Nature Genetics 49 (8): 1255–1260. DOI:10.1038/ng.3895. PMID 28628106. 
  28. ↑ (November 2020) "Genetic predisposition to hypertension is associated with preeclampsia in European and Central Asian women". Nature Communications 11 (1): 5976. DOI:10.1038/s41467-020-19733-6. PMID 33239696. 
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