Publicado

2015-04-01

Hipertensión postparto: una revisión de la literatura y los protocolos de manejo

Postpartum hypertension: literature review and management protocols

Palabras clave:

Hipertensión postparto, pre-eclampsia postparto, manejo, tratamiento. (es)
Pregnancy induced hypertension, Pre-eclampsia, Postpartum period, Management, Treatment (en)

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Autores/as

  • Anuar Alonso Cedeño-Burbano Facultad de Ciencias de la Salud. Universidad del Cauca. Popayán, Colombia.
  • Gerardo Alfonso Galeano-Triviño Facultad de Ciencias de la Salud. Universidad del Cauca. Popayán, Colombia.
  • Daniel Alejandro Fernández-Bolaños Facultad de Ciencias de la Salud. Universidad del Cauca. Popayán, Colombia.
  • Karen Liseth Chito-castro Facultad de Ciencias de la Salud. Universidad del Cauca. Popayán, Colombia.
  • Valentina Coronado-Abella Facultad de Ciencias de la Salud. Universidad del Cauca. Popayán, Colombia.

Antecedentes. La hipertensión postparto corresponde a la presencia de cifras tensionales sistólicas superiores a 140 mmHg o diastólicas mayores a 90 mmHg, medidas en 2 ocasiones con una diferencia de 4 horas; las cuales aparecen o se sostienen en el puerperio, hasta las 12 semanas posteriores al parto (1,2). Actualmente, a excepción de la crisis hipertensiva, el manejo de la hipertensión en el posparto no está estandarizado.

Objetivo. Realizar una revisión bibliográfica acerca del manejo de la hipertensión postparto, exceptuando la crisis hipertensiva.

Materiales y métodos. Se realizó una búsqueda de la literatura publicada en las bases de datos: Pubmed, Tripdatabase, Science Direct, Embase biomedical, Scielo y Ebsco, con los términos: postpartum period, pregnancy induced hypertension, pregnancy induced hypertension and diagnosis, pregnancy induced hypertension and treatment, postpartum hypertension and management; en inglés y con sus equivalentes en español, sin limitación cronológica.

Resultados. Se obtuvieron alrededor de 55 artículos con información oportuna para cumplir con los objetivos de la presente revisión; entre ellos, una revisión sistemática, cuatro ensayos clínicos y dos guías de manejo.

Conclusión. A pesar de que existen muchos fármacos considerados compatibles con la lactancia, existe poca evidencia sobre su seguridad para el lactante. No se recomienda el manejo farmacológico de la hipertensión postparto leve a moderada. El manejo con fármacos antihipertensivos es mandatorio en hipertensión severa.

Background. Postpartum hypertension is the presence of systolic pressure over 140 mmHg or diastolic over 90 mmHg, measured on 2 occasions with a difference of four hours; which appear or continue at postpartum period until 12 weeks after delivery (1,2). Currently, except hypertensive crisis, the management of hypertension in the postpartum period is not standardized.

Objective. To conduct a literature review on the management of postpartum hypertension, except hypertensive crisis.

Materials and methods. A search of the literature published in the following databases was performed: PubMed, Tripdatabase, Science Direct, Embase biomedical, Scielo and Ebsco; without chronological limitation, and with the terms (both in English and Spanish): postpartum period, pregnancy induced hypertension, pregnancy induced hypertension and diagnosis, pregnancy induced hypertension and treatment, postpartum hypertension and management.

Results. Approximately 55 articles relevant to meet the objectives of this review were obtained; including a systematic review, four clinical trials and two management guidelines.

Conclusion. Although there are many drugs considered compatible with breastfeeding, there is little evidence of safety for the infant. Pharmacological management of mild to moderate postpartum hypertension is not recommended. Management with antihypertensive drugs is mandatory in severe hypertension.

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