Preeclampsia - abdominal hypertension syndrome in pregnancy. whether a hypothesis will become a theory?

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Abstract

Based on the analysis of literature and their own data the authors presented modern aspects of the etiology and pathogenesis of preeclampsia from the perspective of intra-abdominal hypertension syndrome. The data are collected from a large representative sample of 647 patients at various stages of gestation. It was shown that elevated levels of intra-abdominal pressure at 20-24 weeks of pregnancy in some cases preceded the development of preeclampsia. The level of intra-abdominal pressure, preceding the development of preeclampsia in pregnant women with obesity, was significantly higher than that of normal-weight patients (p <0.001). Along with the level of intra-abdominal pressure, the rate of its increase plays an important role in the preeclampsia development, with a greater degree than the absolute value of the intra-abdominal pressure. Pregnant women with a rapid and substantial increase in intra-abdominal pressure (more than 4 mm Hg for 2 weeks of gestation) are more likely to have complications of pregnancy than patients with an increase in intra-abdominal pressure less then 2 mm Hg in a given time interval (p <0.001), while the higher the increase in intra-abdominal pressure, at the earlier stages complication develops. The article also provides information about the dynamics of intra-abdominal pressure during pregnancy, relationships of intra-abdominal hypertension with parameters of utero-placental blood flow, renal hemodynamics, intestinal perfusion and permeability, level of endotoxemia in pregnant women. Based on the results of their own investigations, the authors suggest a model of preeclampsia development as a consequence of intra-abdominal hypertension syndrome.

About the authors

D V Marshalov

Saratov State Medical University named after V.I. Razumovsky

Author for correspondence.
Email: MarshalD@mail.ru

E M Shifman

Moscow Regional Scientific and Research Clinical Institute named after M.F. Vladimirskiy

Email: MarshalD@mail.ru

I A Salov

Saratov State Medical University named after V.I. Razumovsky

Email: MarshalD@mail.ru

A P Petrenko

Saratov State Medical University named after V.I. Razumovsky

Email: MarshalD@mail.ru

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© 2016 Marshalov D.V., Shifman E.M., Salov I.A., Petrenko A.P.

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