Current panorama of preeclampsia in Mexico and in the world

Abstract

Hypertensive disorders of pregnancy include gestational hypertension, preeclampsia with or without severity indicators, and eclampsia. Among these, preeclampsia shows high rates of morbidity and mortality; therefore, it is important to understand the current epidemiological landscape for its prevention, detection, and quality care. This research explores the current landscape of preeclampsia and updates on its diagnosis, treatment, management, and sociodemographic factors that impact its incidence at both national and global levels. A systematic review of related articles shows an increase in incidence among Mexican patients and delays in diagnosis and treatment, especially in isolated areas. This increase has been observed over the last ten years, primarily led by the central and southern regions of the country, with rates up to 49%. The classification by levels is replaced by preeclampsia without severity indicators and preeclampsia with severity indicators. For diagnosis and screening, the widespread use of Doppler ultrasound of the uterine arteries and the detection of circulating levels of placental growth factor have been incorporated. The management of this disease has updated the antihypertensive medications used and the target blood pressure goals. The effects of this pathology on society become more evident among countries and communities due to distrust in healthcare personnel present in some societies, leading to unfavorable outcomes for first-time mothers and their families. In Mexico, the difference in incidence compared to developed countries is not significant (2%), but mortality does report an increase (WHO, 2005), which is not observed when compared to developing countries, where morbidity is similar but mortality is lower. Screening strategies are the most important factor for achieving timely diagnosis, and standardization in the management and monitoring of obstetric patients at risk of developing preeclampsia is necessary.