Modern aspects of identifying and managing pregnant women with preeclampsia

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Abstract

This article explores the importance of early detection and systematic monitoring of pregnant women with preeclampsia at the stage of consultation in the antenatal clinic, management of labor and the postpartum period. The authors, based on their experience working at City Clinical Hospital No. 52 in Moscow, consider the features of diagnosing this complication, methods for monitoring the condition of patients and effective pregnancy management strategies to prevent possible complications (such as eclampsia and HELLP syndrome). The main emphasis of the article is on the importance of prenatal screening, regular assessment of blood pressure, protein levels in the urine and other clinical indicators during observations at the prehospital stage and in the departments of the maternity hospital. The results and recommendations obtained provide valuable information for healthcare institutions and medical personnel monitoring and managing pregnant women at risk of developing preeclampsia. Preeclampsia is one of the most dangerous complications of pregnancy, which can lead to irreversible consequences for the mother and fetus. One of the key factors for success in the treatment of preeclampsia is early detection and dynamic monitoring of patients at all stages of pregnancy. This article presents aspects of identifying preeclampsia at the stage of antenatal clinic, maternity hospital and the role of midwives in this process.

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About the authors

Anna V. Sakharova

State Budgetary Healthcare Institution «City Clinical Hospital №52 of the Moscow City Health Department»

Author for correspondence.
Email: Agarkova21@mail.ru
ORCID iD: 0009-0005-0629-5780

senior nurse of general hospital medical staff No. 2

Russian Federation, Moscow

Yulia V. Markelova

State Budgetary Healthcare Institution «City Clinical Hospital №52 of the Moscow City Health Department»

Email: MarkelovaYV@zdrav.mos.ru
ORCID iD: 0009-0008-7333-7903

Bachelor of Nursing, Master of Psychological and Pedagogical Education, methodologist

Russian Federation, Moscow

Elena A. Sokolova

State Budgetary Healthcare Institution «City Clinical Hospital №52 of the Moscow City Health Department»

Email: elena-sokolova-25@inbox.ru
ORCID iD: 0000-0002-0353-4302

deputy chief physician for work with nursing staff

Russian Federation, Moscow

Natalia V. Sukhotina

State Budgetary Healthcare Institution «City Clinical Hospital №52 of the Moscow City Health Department»

Email: tusot@yandex.ru
ORCID iD: 0000-0003-4309-8258

chief nurse

Russian Federation, Moscow

References

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  2. Savelieva G.M. Obstetrics: national guide / ed. by G. M. Savelieva, G. T. Sukhikh, V. N. Serov, V. E. Radzinsky. 2nd ed., revision and supplement Moscow: GEOTAR-Media, 2022. 1080 с. (Series «National Guidelines»). ISBN 978-5-9704-6632-2.
  3. Clinical recommendations «Preeclampsia. Eclampsia. Edema, proteinuria and hypertensive disorders during pregnancy, labor and postpartum» — 2021-2022-2023 (24.06.2021). Approved by the Ministry of Health of the Russian Federation. URL: http://disuria.ru/_ld/10/1046_kr21O10O16MZ.pdf (date of circulation 12.10.2023).
  4. Order of the Ministry of Health of November 20, 2020 №1130 n «On Approval of the Procedure for the provision of medical care in the profile of «obstetrics and gynecology». URL: https://base.garant.ru/74840123/ (date of circulation 12.10.2023).
  5. National Institute for Clinical Excellence et al. PlGF-based testing to help diagnose suspected pre-eclampsia (Triage PlGF test, Elecsys immunoassay sFlt-1/PlGF ratio, DELFIA Xpress PlGF 1-2-3 Test, and BRAHMS sFlt-1 Kryptor/BRAHMS PlGF plus Kryptor PE ratio) // London, UK: NICE. 2016.
  6. Henderson J.T., Whitlock E.P., O’Conner E. et al: Table 8: Preeclampsia Risk Factors Based on Patient Medical History in Low-dose aspirin for the prevention of morbidity and mortality from preeclampsia: A systematic evidence review for the U.S. Preventive S
  7. American College of Obstetricians and Gynecologists (ACOG): Gestational hypertension and preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 135 (6): 237–260; 2020.
  8. Roberge S., Nicolaides K., Demers S. et al: The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: a systematic review and meta-analysis. Am J Obstet Gynecol 216 (2): 110–120; 2017. doi: 10.1016/j.ajog.2016.09.076
  9. Order of the Ministry of Labor of Russia from 31.07.2020 № 479n «On approval of professional standard «Specialist in nursing organization». URL: https://www.garant.ru/products/ipo/prime/ doc/74422142/ (date of circulation 12.10.2023).
  10. Order of the Ministry of Education of the Russian Federation from July 21, 2022 № 587 «On approval of the federal state educational standard of secondary vocational education on specialty 31.02.02 Midwifery». URL: https://base.garant.ru/405161937/ (date of circulation 12.10.2023).
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Supplementary files

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2. Fig.1. Basic terms.

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3. Fig. 2. Risk factors for developing preeclampsia.

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4. Fig. 3. Stages of prenatal screening.

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5. Fig. 4. Laboratory diagnostic studies of patients at risk of developing preeclampsia.

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6. Fig. 5. Instrumental diagnostic studies at high risk of developing preeclampsia.

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7. Fig. 6. Quantitative screening indicators “Risk Markers of Preeclampsia” in antenatal clinics.

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8. Fig. 7. Quantitative indicators of childbirth complicated by preeclampsia.

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9. Fig. 8. Statistics on the incidence of preeclampsia and eclampsia.

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