gestóza

Gestóza, or gestosis, is a hypertensive disorder of pregnancy defined by the onset of high blood pressure after 20 weeks of gestation, often accompanied by proteinuria or signs of organ dysfunction. In contemporary obstetrics, the term covers preeclampsia and its severe forms, including eclampsia and HELLP syndrome. Diagnosis relies on new hypertension (systolic 140 mmHg or diastolic 90 mmHg or higher, on two occasions at least four hours apart) and evidence of proteinuria (≥300 mg/24 hours or protein/creatinine ratio ≥0.3) or, in the absence of proteinuria, signs of systemic involvement such as elevated liver enzymes, reduced platelets, kidney impairment, cerebral or visual symptoms, or pulmonary edema.

Risk factors include first pregnancy, maternal age outside the 20s–30s range, obesity, chronic hypertension, diabetes, kidney disease, autoimmune disorders, multiple gestation, and a history of preeclampsia. The condition is considered placental in origin, involving abnormal placentation and systemic endothelial dysfunction, which can affect multiple organ systems.

Management depends on severity and gestational age. Mild cases may involve close monitoring, blood pressure control, and fetal surveillance, sometimes with expectant management if the pregnancy is near term. Severe features or threat to mother or fetus require hospitalization, antihypertensive therapy (for example, labetalol or nifedipine), and magnesium sulfate for seizure prophylaxis if preeclampsia with severe features is suspected. Delivery is the definitive treatment, with timing balancing maternal safety and fetal maturity. Postpartum resolution is common, but late complications can occur.