The Role of Prenatal Preparation of Women in the Prevention of Relapse of Severe Preeclampsia during Subsequent Pregnancy

Abstract

Pre-eclampsia is one of the most pressing problems in modern obstetrics, as reliable early prognostic and diagnostic markers, as well as effective prevention and treatment strategies, remain limited. The condition is associated with high maternal and perinatal mortality, ranging from 12.1% to 23.2%. In addition, the incidence of low-symptom and atypical forms of pre-eclampsia has increased.

The most widely accepted hypothesis of pre-eclampsia pathogenesis involves an imbalance between angiogenic and antiangiogenic factors, including VEGF, PlGF, and their tyrosine kinase receptors, resulting from placental hypoxia.

Pre-eclampsia complicates 6–8% of pregnancies in developing countries and approximately 0.4% in developed countries. The incidence of secondary pre-eclampsia is 5.2%, increasing to 18.4% in moderate arterial hypertension and up to 100% in severe chronic hypertension. Recent studies have shown that secondary pre-eclampsia may persist for more than two years after childbirth.

Thus, the development of pre-eclampsia during pregnancy can lead to serious complications and increase the risk of recurrence in subsequent pregnancies. Therefore, prevention of recurrent pre-eclampsia, particularly during the preconception period, remains an urgent clinical problem.