Beneficios y riesgos de la terapia antihipertensiva en el posparto

Adriana Marcela Arenas-Rojas

Resumen


Introducción: los trastornos hipertensivos son la complicación médica más común del embarazo, con una prevalencia mundial de 5 – 10%, y son una causa importante de morbimortalidad, especialmente en países en vía de desarrollo. Existe muy poca información acerca de la evaluación, tratamiento y complicaciones de las pacientes hipertensas durante el puerperio y la falta de guías de manejo de esta patología suele resultar en diagnósticos imprecisos y estrategias de manejo incorrectas. Objetivo: proveer un enfoque acerca de los beneicios y riesgos de los fármacos antihipertensivos en el manejo de la hipertensión posparto. Métodología de búsqueda: se realizó una revisión de la literatura en las bases bibliográicas PubMed, Science Direct, Embase, SciELO y LILACS, limitando la búsqueda a artículos de los últimos 10 años, en español e inglés. Se excluyeron aquellos que no contenían información acerca de la presentación clínica, el tratamiento o las complicaciones de la hipertensión posparto. Resultados: se obtuvo un total de 69 artículos que cumplían los criterios para ser incluidos en esta revisión. Discusión y Conclusiones: debido a la limitación de la literatura acerca del manejo de la hipertensión posparto, no es adecuado hablar de fármacos de primera línea; la elección del mismo es guiada por la etiología subyacente y se deben tener en cuenta factores como la lactancia materna. Los fármacos propuestos pertenecen a los grupos de antagonistas de canales de calcio, β-bloqueadores, bloqueadores del eje renina-angiotensina-aldosterona, diuréticos, α-bloqueadores, entre otros. Se destacan como los más usados: nifedipino, metildopa, y β-bloqueadores como propanolol y labetalol, debido a la evidencia soportando la seguridad de su uso durante el puerperio. MÉD.UIS. 2016;29(2):71-80.

Palabras clave: Hipertensión inducida en el embarazo. Puerperio. Antihipertensivos. Tratamiento.


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DOI: http://dx.doi.org/10.18273/revmed.v29n2-2016007

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