Maternal medicine in motion: multidisciplinary approach to hypertensive disorders in pregnancy

Abstract

This dissertation focuses on improving care for women with increased risk of hypertensive complications in pregnancy, such as complex autoimmune diseases like Systemic Lupus Erythematosus (SLE). Women with SLE face higher risks of preterm birth, perinatal mortality, and cardiovascular issues like hypertension and pre-eclampsia. Research shows that a new care pathway, involving a multidisciplinary team, can enhance outcomes by creating personalized treatment plans and reducing disease flare-ups during pregnancy. Identifying risk factors for adverse pregnancy outcomes, such as pre-existing hypertension and lupus nephritis, helps doctors better assess risks and tailor care.

The second part of the dissertation explores the sFlt-1/PlGF ratio blood test for predicting pre-eclampsia, with promising results when combined with urine protein tests and self-monitoring apps for blood pressure. Plasma exchange therapy is also examined as a potential treatment for pre-eclampsia, though its safety and effectiveness during pregnancy are still uncertain. Overall, the dissertation emphasizes the importance of multidisciplinary collaboration, innovative care models, and advanced diagnostics in improving pregnancy outcomes for women with autoimmune diseases, aiming to reduce hypertensive complications and enhance maternal and fetal health.