Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review
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Sousa Gomes, Maria Luziene
Rodrigues, Ivana Rios
Rolnik, Daniel Lorber
Costa, Fabricio Silva
Batista Oria, Monica Oliveira
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OBJECTIVE: To identify the most effective procedures recommended for the prevention of preeclampsia. DATA SOURCES: A systematic review was performed in the following databases: Pubmed/MEDLINE, CINAHL, Web of Science, Cochrane and LILACS via the Virtual Health Library (VHL). A manual search was also performed to find additional references. The risk of bias, the quality of the evidence, and the classification of the strength of the recommendations were evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. SELECTION OF STUDIES: In the initial search in the databases, the total number of articles retrieved was 351, and 2 were retrieved through the manual search; after duplicate articles were removed, 333 citations remained. After a thorough review of the titles and abstracts, 315 references were excluded. Accordingly, 18 articles were maintained for selection of the complete text (phase 2). This process led to the exclusion of 6 studies. In total, 12 articles were selected for data extraction and qualitative synthesis. DATA COLLECTION: The articles selected for the study were analyzed, and we inserted the synthesis of the evidence in the online software GRADEpro Guideline Development Tool (GDT) (McMaster University and Evidence Prime Inc. All right reserved. McMaster University, Hamilton, Ontário, Canada); thus, it was possible to develop a table of evidence, with the quality of the evidence and the classification of the strength of the recommendations. DATA SYNTHESIS: In total, seven studies recommended the individual use of aspirin, or aspirin combined with calcium, heparin or dipyridamole. The use of calcium alone or in combination with phytonutrients was also highlighted. All of the studies were with women at a high risk of developing preeclampsia. CONCLUSION: According to the studies evaluated, the administration of aspirin is still the best procedure to be used in the clinical practice to prevent preeclampsia.
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Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics
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42
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10
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© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
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Obstetrics and gynaecology
Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
pregnant women
preeclampsia
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Moura, NS; Sousa Gomes, ML; Rodrigues, IR; Rolnik, DL; Costa, FS; Batista Oria, MO, Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review, Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 2020, 42 (10), pp. 659-668