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Resultados cardíacos adversos en el feto y la madre en enfermedades reumáticas: una revisión sistemática
E Manouchehri1, N Jazayerinezhad2, Z Oskoueyan3
1Assistant Professor of Reproductive Health, Department of Nursing and Midwifery, MMS.C., Islamic Azad University, Mashhad, Iran.
Resumen
El tratamiento de los trastornos reumáticos autoinmunes (TRA) durante el embarazo requiere atención colaborativa. Las estrategias de manejo adaptadas son cruciales para mejorar los resultados cardíacos maternos y fetales en estos embarazos complejos.
Área de la Ciencia:
- Reumatología
- Cardiología
- Medicina materna y fetal
Sus antecedentes:
- Los trastornos reumáticos autoinmunes (TRA) presentan desafíos únicos durante el embarazo.
- Las complicaciones pueden variar significativamente según la actividad de la enfermedad y el tratamiento.
Objetivo del estudio:
- Revisar sistemáticamente los resultados cardíacos maternos y fetales en mujeres embarazadas con DRA.
- Identificar los resultados adversos cardiovasculares comunes y los factores de riesgo.
Principales métodos:
- Se realizó una revisión sistemática exhaustiva de las bases de datos electrónicas hasta agosto de 2024.
- Se incluyeron 53 estudios en los que participaron más de 15 millones de mujeres.
- Riesgo de sesgo evaluado mediante la herramienta de evaluación de métodos mixtos (MMAT).
Principales resultados:
- El lupus eritematoso sistémico y la artritis de Takayasu fueron las DRA estudiadas con mayor frecuencia.
- La preeclampsia-eclampsia fue el resultado cardiovascular maternal más común.
- El bloqueo cardíaco congénito fue el resultado cardíaco fetal/neonatal más frecuente.
- Los resultados de la artritis reumatoide fueron controvertidos; el 96% de los estudios tenían riesgos de sesgo.
Conclusiones:
- La atención integral colaborativa es vital para el manejo de los embarazos con DRA.
- La atención personalizada mejora los resultados tanto para las madres como para los fetos.
- Se necesita más investigación para abordar el sesgo y los hallazgos controvertidos.
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