Актуальные вопросы патогенеза и профилактики преэклампсии

Одним из наиболее грозных осложнений беременности, ассоциированных с артериальной гипертензией, является преэклампсия. Для эффективной профилактики заболевания необходимо четкое понимание механизмов ее развития. В статье представлен анализ современных моделей, отражающих причины и механизмы развития преэклампсии, а также обоснование доказательных стратегий профилактики этой патологии, наиболее зарекомендовавших себя в настоящее время. В основе патогенеза преэклампсии лежит генерализованная эндотелиальная дисфункция матери, обусловленная плацентарными факторами, генетической предрасположенностью и недостаточной сосудистой инвазией в клетки трофобласта, вследствие чего развиваются оксидативный стресс и воспалительный процесс, приводящие к осложнениям со стороны матери и плода. Более точное понимание механизмов заболевания позволяет эффективно корректировать неблагоприятные факторы образа жизни и выделять пациентов группы риска развития преэклампсии, которым необходимо назначать профилактику. Достоверно эффективным и общепринятым терапевтическим средством на данным момент является ацетилсалициловая кислота, назначаемая в качестве профилактики с 11–14-й недели в оптимальной дозировке от 75 до 162 мг.

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