| Abstract [eng] |
Hypertensive disorders of pregnancy remain one of the leading causes of maternal and foetal morbidity and mortality worldwide. This group includes chronic arterial hypertension, gestational hypertension, pre-eclampsia, and other pregnancy-related hypertensive conditions. In recent years, the principles of diagnosis and management of these conditions have changed considerably, with increasing emphasis placed on earlier risk assessment, blood pressure control, treatment initiation thresholds, and the long-term cardiovascular risk to women following pregnancy. Therefore, it is important to evaluate the most recent international recommendations and discuss their clinical relevance. To achieve this, a search of scientific literature sources was conducted using the international database PubMed. In addition, purposefully selected international and national clinical documents were included in the literature review. Particular attention was given to the guidelines and publications of the European Society of Cardiology, the American Heart Association, the American College of Obstetricians and Gynaecologists, and the Ministry of Health of the Republic of Lithuania. Based on the selected literature, hypertensive disorders during pregnancy constitute a heterogeneous group of conditions associated with a significantly increased risk of complications for the mother, foetus, and newborn. This review examines the classification, epidemiology, risk factors, and pathophysiological mechanisms of these conditions. The principles of diagnosis are discussed, including blood pressure assessment as well as laboratory and instrumental investigations. Management strategies, indications for antihypertensive therapy, the choice of pharmacological treatment during pregnancy, the importance of timing of delivery, and aspects of postnatal care are also evaluated. Furthermore, the long-term risk of cardiovascular disease in women who experienced hypertensive disorders during pregnancy is discussed. Literature analysis demonstrated that the latest international guidelines reflect a shift towards earlier management of hypertension during pregnancy. Greater emphasis is placed not only on the prevention of severe complications but also on early diagnosis, stricter blood pressure control, and an individualised risk-assessment strategy. Comparison of different guidelines revealed certain differences in diagnostic and therapeutic approaches; however, the overarching objective remains the same – to reduce the risk of maternal and foetal complications and to ensure long-term cardiovascular health in women. From a practical perspective, it is important to strengthen the early identification of risk factors, implement a multidisciplinary model of patient care, and ensure consistent postnatal follow-up. |
