Análise dos óbitos fetais relacionados às síndromes hipertensivas: revisão integrativa

Abstract

During pregnancy, high blood pressure is a hypertensive disorder of pregnancy, representing one of the main causes of maternal and perinatal morbidity and mortality in Brazil and worldwide. Hypertensive syndromes during pregnancy require in-depth investigation, since their impact on maternal and fetal health is significant. In this context, studies that identify the factors associated with fetal death resulting from these syndromes become essential, allowing the scientific and professional community to develop effective strategies for early detection of risk and the implementation of measures aimed at reducing perinatal mortality rates. Thus, the aim was to analyze the relationship between fetal deaths due to hypertensive syndromes. This is an integrative literature review with a quantitative approach, divided into six structuring phases. The acronym PICo was used, in which P (Person or Problem) was attributed pregnancy- induced hypertension, I (Intervention) high-risk pregnancy, Co (context) fetal death. Thus, the following guiding question was developed: “Do women who present hypertensive syndromes during pregnancy have a higher risk of developing fetal death?”. The databases used were: Scopus, MEDLINE via PubMed, Embase and Latin American and Caribbean Literature in Health Sciences (LILACS) via Virtual Health Library (BVS) and Scientific Electronic Library Online (SCIELO). Initially, 1,192 studies were identified in the selected databases. After applying the exclusion criteria, which included reading the title and abstract, followed by a more detailed analysis, 16 articles remained for the final analysis. There was a balance in relation to the year of publication, 25% of the articles published in 2020, 25% in 2021, 25% in 2022, 18.8% in 2023 and 6.2% in 2024. Regarding the language, all studies were published in English, except one study, also published in Portuguese and Spanish. The results show that gestational hypertension was associated with fetal deaths in 10 studies, chronic hypertension in 8 studies, and chronic hypertension with superimposed pre-eclampsia in 3 studies. Pre- eclampsia was the condition most frequently associated with fetal deaths, being reported in 12 studies, followed by eclampsia in 6 studies and HELLP syndrome in 3 studies. The analysis of the data extracted from the 16 selected studies confirmed that women who develop hypertensive syndromes during pregnancy have a significantly increased risk of fetal death. This finding highlights the need for a more in-depth approach to the impacts of these conditions on perinatal mortality, encouraging the formulation of effective strategies for the early identification and mitigation of this risk.