Gestational sleep apnea. The association between pregnancy and preeclampsia with obstructive sleep apnea syndrome

Abstract

Preeclampsia (PE) continues to be one of the main reasons of maternal mortality even in countries with a high level of medical care. Current PE treatment can be etiological and symptomatic. Therefore, active investigation into etiology and pathogenesis of this pregnancy complication is on the way. Identification of new pathways in PE is of vital importance because it could provide clues to pathogenesis-related treatment and consequent reduction in mortality. It is especially in the mainstream nowadays, when leading world perinatal institutions have focused on prolongation of pregnancy in early onset PE (EPE) to improve neonatal outcomes. Obstructive sleep apnea (OSA) syndrome and early small airway obstruction have been proposed as pathophysiological pathways of PE. In this review article we present the association between pregnancy and sleep-related breathing dysfunction, as well as between OSA and hypertensive disorders of pregnancy. Common mechanisms for arterial hypertension in PE and OSA have been proposed, and additional potential treatment approaches are discussed aimed at pregnancy prolongation in EPE. We have formulated unresolved issues related to studies of obstructive sleep apnea in pregnancy in general and in PE patients in particular.

Keywords

• preeclampsia
• pregnancy prolongation with early onset preeclampsia
• hypertensive disorders of pregnancy
• arterial hypertension
• obstructive sleep apnea
• early small airway obstruction
• cpap
• respiratory therapy
• blood gases