Supervisors info:
Μυριανθεύς Παύλος, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Φιλντίσης Γεώργιος, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Θεόδωρος Κατσούλας, Αναπληρωτής Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Introduction - Background: Pregnancy is a long-lasting process during which the maternal organs are called to adapt to new conditions. However, sometimes, occur complications that need to be treated immediately. Such cases are the hypertensive disorders of pregnancy, mainly preeclampsia, eclampsia, and HELLP syndrome. Preeclampsia is defined as gestational hypertension accompanied by proteinuria or other maternal organ dysfunction that occurs from 20 weeks of gestation onwards. Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia, provided that there is no other cause of the seizures. HELLP syndrome is a life-threatening condition, which is defined by hemolysis, elevated liver enzymes and low platelets. Their treatment is based on the administration of antihypertensive agents, magnesium sulfate and, in the case of eclampsia, benzodiazepines to control the seizures.
Aim: The aim of this review is to research the management of preeclampsia, eclampsia and HELLP syndrome, as well as the outcome of these patients in Intensive Care Units around the world.
Methodology: A systematic review of the literature was conducted in the international database PubMed from January 2020 to June 2020, on the management and outcome of women with preeclampsia, eclampsia and HELLP syndrome in the ICU. The criteria for inclusion of the studies were the English or Greek language, year > 2000 and the content of the studies should be regarding the treatment and / or outcome of preeclampsia, eclampsia or HELLP syndrome in the ICU. Results: In developed countries, preeclampsia is diagnosed early and treated successfully with antihypertensive agents and magnesium sulfate, greatly reducing the incidence of its complications, including eclampsia and HELLP syndrome. These societies are now focusing on the study of a possible genetic background and biomarkers of these syndromes, as well as more specific subgroups of women, such as pregnancies achieved through assisted reproduction. On the contrary, developing countries are still facing very high rates of serious maternal and fetal complications, as well as high mortality rate. Poverty, difficult access to health services, lack of trained staff and appropriate drugs, lack of information and lack of laboratory and clinical testing before childbirth, contribute significantly to the increased number of deaths of young and productive women. Conclusions: While there is an established treatment for the aforementioned syndromes, the gap between developed and developing countries is huge, resulting in a large number of deaths that could have been prevented.
Keywords:
Preeclampsia, Eclampsia, HELLP Syndrome, Management, Outcome, ICU
