Impact of gestational hypertension and preeclampsia on maternal and fetal morbidity and mortality: a literature review

Abstract

Introduction: Gestational hypertension and preeclampsia are major causes of maternal and fetal morbidity and mortality, with a direct impact on survival and neonatal outcomes. Therefore, physical therapy plays a fundamental role in promoting the health of pregnant women, helping to prevent cardiovascular complications, improve respiratory function, and control edema and musculoskeletal pain. Objective: A literature review was conducted to synthesize evidence on the impact of physical therapy on gestational hypertension and preeclampsia on maternal and fetal morbidity and mortality with a focus on the work between physical therapy and medicine. Methods: This is a descriptive and analytical literature review based on national and international publications available in the Virtual Health Library (VHL), Latin American and Caribbean Health Sciences Literature (LILACS), United States National Library of Medicine (PubMed), and Cochrane Library. Studies published between 2018 and 2024 were included, addressing prevalence, pathophysiology, maternal and fetal repercussions, and preventive and therapeutic interventions. Results: The literature indicates that gestational hypertension and preeclampsia significantly increase the risks of maternal complications, including eclampsia, hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome), and maternal death, as well as adverse fetal outcomes, such as intrauterine growth restriction, prematurity, and perinatal death. Risk stratification, intensive monitoring, and the adoption of standardized clinical protocols have been shown to reduce these complications. Preventive strategies, such as calcium supplementation in at-risk pregnant women and multidisciplinary care during prenatal care, have been shown to be effective in reducing the incidence of severe preeclampsia and adverse events. The studies analyzed indicate that physical therapy during prenatal care reduces symptoms associated with gestational hypertension, improves cardiorespiratory fitness, optimizes venous return, and aids in blood pressure control. Interventions such as low-impact therapeutic exercises, stretching, manual lymphatic drainage, and breathing techniques have been shown to be effective in reducing edema, low back pain, and fatigue, as well as promoting autonomic balance and emotional well-being. Conclusion: The management of gestational hypertension and preeclampsia requires an interdisciplinary approach, involving early diagnosis, continuous monitoring, risk stratification, and multidisciplinary action. Investments in standardized clinical protocols, professional training, and equitable access to referral services are essential to reduce maternal and fetal morbidity and mortality, promoting safety and better perinatal outcomes.