Review
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PREECLAMPSIA, MATERNAL AND FETAL EFFECTS, MANAGEMENT, INTERVENTIONS FOR PREVENTION AND NURSING ROLE

Year 2019, Volume: 50 Issue: 2, 75 - 81, 15.06.2019
https://doi.org/10.16948/zktipb.358118

Abstract

Preeclampsia remains a principal cause of maternal and
fetal morbidity and mortality. In addition, it is responsible for 70,000
maternal deaths and 500,000 infant deaths annually.
Preeclampsia
poses a risk for some complications such as maternal renal insufficiency and
liver involvement organ dysfunction or uteroplacental dysfunction and fetal
growth restriction. The protective approaches for preeclampsia gain importance
because maternal-fetal morbidity and mortality is high, and etiology and
pathogenesis are not completely known. Nurses can play a critical role in
diagnosis, assessment and management of women at risk for preeclampsia. It is
highlighted in the studies that adequate antenatal care in terms of quality and
quantity is beneficial for diagnosed with risky or mild preeclampsia women.
Nurses need to know how to administer nursing care in the management of
preeclampsia. In literature there are many studies about preeclampsia but there
are few studies about preeclampsia and nursing care. It is thought that
scientific studies in this subject will contribute to the preservation of
maternal and neonatal health by providing quality nursing care to pregnant
women at risk of preeclampsia.

References

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  • 2. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. The Lancet Global Health 2014; 2:e323-33.
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  • 4. August P, Sibai BM. “Preeclampsia: Clinical Features and Diagnosis”. Up To Date 2017 (online). Available from: www.UpToDateInc.com/card INTERNET. Accessed 2016 May 15.
  • 5. Mol Ben W J, Roberts CT, Thangaratinam S, Magee LA, Groot CJM, Hofmery GJ. Pre-eclampsia. Lancet 2016; 387:999-1011.
  • 6. Norwitz ER. “Eclampsia”. In: Up To Date 2017 (online). Available from: www.UpToDateInc.com/card INTERNET. Accessed 2016 May 16.
  • 7. Roberts JM. Hypertension in Pregnancy. The American Collage of Obstetricians and Gynecologists 2012-2013.
  • 8. English FA, Kenny LC, McCarthy FP. Risk factors and effective management of preeclampsia. Integrated Blood Pressure Control 2015; 8 7-12.
  • 9. Türkiye Halk Sağlığı Kurumu Kadın ve Üreme Sağlığı Dairesi Başkanlığı, Anne Ölümleri 2014. http://www.halksagligi.hacettepe.edu.tr/sunumlar_ve_seminerler/20mart_Sempozyum/Anne_olumleri.pdf [erişim:01.06.2016].
  • 10. Vest AR, Cho LS. Hypertension in pregnancy. Current atherosclerosis reports 2014; 16(3), 1-11.
  • 11. Milne F, Redman C, Walker J, Baker P, Bradley J, Cooper C et all. The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community. Bmj 2005; 330(7491), 576-80.
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  • 13. Gallos ID, Sivakumar K, Kilby M, Coomarasamy A, Thangaratinam S, Vatish M. Preeeclampsia is associated with, and preceded by, hypertriglyceridaemia: a meta-analysis. BJOG: An International Journal of Obstetrics & Gynaecology 2013; 120(11), 1321-1332.
  • 14. Ozan YD, Ertuğrul M, Okumuş H. Preeklampsi Tanılama, Değerlendirme ve Hemşirelik Yönetimi. Cumhuriyet Hemşirelik Dergisi 2012; 2, 59-65.
  • 15. Spracklen CN, Smith CJ, Saftlas AF, Robinson JG, Ryckman KK. Maternal hyperlipidemia and the risk of preeclampsia: a meta-analysis. American journal of epidemiology 2014; 180(4), 346-358.
  • 16. Swank M, Nageotte M, Hatfield T. Necrotizing pancreatitis associated with severe preeclampsia. Obstetrics & Gynecology 2012; 120, 453-5.
  • 17. Lynch TA, Dexter SC. Alcoholic Pancreatitis Masquerading as Preeclampsia. Obstetrics & Gynecology 2015; 126(6), 1276-8.
  • 18. Ødegård RA, Vatten LJ, Nilsen ST, Salvesen KÅ, Austgulen R. Preeclampsia and fetal growth. Obstetrics & Gynecology 2000; 96(6), 950-5.
  • 19. Townsend NS, Drummond SB. Preeclampsia: Pathophysiology and implications for care. The Journal of perinatal & neonatal nursing 2011; 25(3), 245-52.
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  • 21. Villar J, Abdel-Aleem H, Merialdi M, Mathai M, Ali MM, Zavaleta N. World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women. American journal of obstetrics and gynecology 2006; 194(3), 639-49.
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  • 26. Hacihasanoğlu R, Gözüm S. The effect of patient education and home monitoring on medication compliance, hypertension management, healthy lifestyle behaviours and BMI in a primary health care setting. Journal of clinical nursing 2011; 20, 692-705.
  • 27. Hypertension in Pregnancy (Report of the ACOG Task Force on Hypertension in Pregnancy) Obstetrics & Gynecology 2013; 122 (5).
  • 28. Stratta P, Canavese C, Porcu M, Dogliani M, Todros T, Garbo E. Vitamin E supplementation in preeclampsia. Gynecologic and obstetric investigation 1994; 37(4), 246-9.
  • 29. Gülmezoğlu AM, Hofmeyr GJ, Oosthuisen MM. Antioxidants in the treatment of severe pre‐eclampsis an explanatory randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology 1997; 104(6), 689-96.
  • 30. Chappell LC, Seed PT, Briley AL, Kelly FJ, Lee R, Hunt BJ. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. The Lancet 1999; 354(9181), 810-6.
  • 31. Roberts JM, Myatt L, Spong CY, Thom EA, Hauth JC, Leveno KJ. Vitamins C and E to prevent complications of pregnancy-associated hypertension. New England Journal of Medicine 2010; 362(14), 1282-91.
  • 32. Xu H, Perez-Cuevas R, Xiong X, Reyes H, Roy C, Julien P. An international trial of antioxidants in the prevention of preeclampsia (INTAPP). American journal of obstetrics and gynecology 2010; 202(3), 239. e1-10.
  • 33. Villar J, Purwar M, Merialdi M, Zavaleta N, Anthony J, De Greeff A. World Health Organisation multicentre randomised trial of supplementation with vitamins C and E among pregnant women at high risk for pre‐eclampsia in populations of low nutritional status from developing countries. BJOG: an International Journal of Obstetrics & Gynaecology 2009; 116(6), 780-8.
  • 34. Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health 2014; (4), 105-145.
  • 35. Wen SW, Champagne J, Rennicks White R, Coyle D, Fraser W, Smith G. Effect of folic acid supplementation in pregnancy on preeclampsia: the folic acid clinical trial study. Journal of pregnancy 2013; ID294312.
  • 36. Abalos E, Duley L, Steyn D, Henderson-Smart D. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy (Review) 2007; (2):CD002252.
  • 37. WHO. Guideline: Calcium supplementation in pregnant women. Geneva, World Health Organization, 2013. http://apps.who.int/iris/bitstream/10665/85120/1/9789241505376_eng.pdf?ua=1 [cited:05.05.2016].
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  • 39. Sørensen JD, Olsen SF, Pedersen AK, Boris J, Seeher NJ, FitzGerald GA. Effects of fish oil supplementation in the third trimester of pregnancy on prostacyclin and thromboxane production. American journal of obstetrics and gynecology 1993; 168(3), 915-22.
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  • 43. Meher S, Duley L. Nitric oxide for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev 2007;(2): CD006490.
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  • 46. Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. The Journal of Clinical Endocrinology & Metabolism 2007; 92(9), 3517-22.
  • 47. Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia. American journal of obstetrics and gynecology 2010; 203(4), 366. e1-6.
  • 48. Shand A, Nassar N, Von Dadelszen P, Inni S, Green T. Maternal vitamin D status in pregnancy and adverse pregnancy outcomes in a group at high risk for pre‐eclampsia. BJOG: An International Journal of Obstetrics & Gynaecology 2010; 117(13), 1593-8.
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Preeklampsi, Maternal ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler ve Hemşirenin Rolü

Year 2019, Volume: 50 Issue: 2, 75 - 81, 15.06.2019
https://doi.org/10.16948/zktipb.358118

Abstract

Preeklampsi
maternal ve perinatal mortalite ve morbiditenin önemli bir nedenidir. Her yıl
dünyada yaklaşık 70.000 anne ölümünden ve 500.000 bebek ölümünden sorumludur. Preeklampsi
mate
rnal renal yetmezlik, böbrek tutulumu gibi organ disfonksiyonu ya da  uteroplesental yetmezlik, fetal büyüme
geriliği gibi komplikasyonlar açısından risk oluşturmaktadır. Preeklampside maternal-fetal
morbidite ve mortalitenin yüksek olması, etiyoloji ve patogenezin tam olarak
bilinmemesi nedeniyle koruyucu yaklaşımların önemi dikkat çekmektedir. Hemşireler
preeklampsinin tanılanması, değerlendirilmesi ve yönetiminde kritik bir role
sahiptirler. Araştırmalarda nitelik ve nicelik bakımından yeterli doğum öncesi
bakım hizmetlerinin, riskli ya da hafif preeklampsi tanısı almış gebelere
yararlı olduğu vurgulanmıştır. Hemşirelerin hasta bakımı ve yönetimini güvenli
bir şekilde sürdürebilmeleri için preeklampsi yönetiminde nasıl bir hemşirelik
bakımı uygulaması gerektiğini bilmeleri gerekmektedir. Literatürde preeklampsi
ile ilgili çok sayıda çalışmaya rastlanırken preeklampsi ve hemşirelik ile
ilgili çalışmaların az olduğu değerlendirilmiştir. Bu konudaki bilimsel çalışmaların
preeklampsi riski taşıyan gebelere kaliteli bir hemşirelik bakımının sağlanması
ile maternal ve neonatal sağlığın korunmasına katkı sağlayacağı
düşünülmektedir.

References

  • 1. First-Trimester Risk Assessment for Early-Onset Preeclampsia. Committee Opinion No. 638. American Collage of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:e25-7.
  • 2. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. The Lancet Global Health 2014; 2:e323-33.
  • 3. Madazlı R. Preeklampsi. Turkiye Klinikleri J Gynecol Obst-Special Topics 2010; 3(1):45-52.
  • 4. August P, Sibai BM. “Preeclampsia: Clinical Features and Diagnosis”. Up To Date 2017 (online). Available from: www.UpToDateInc.com/card INTERNET. Accessed 2016 May 15.
  • 5. Mol Ben W J, Roberts CT, Thangaratinam S, Magee LA, Groot CJM, Hofmery GJ. Pre-eclampsia. Lancet 2016; 387:999-1011.
  • 6. Norwitz ER. “Eclampsia”. In: Up To Date 2017 (online). Available from: www.UpToDateInc.com/card INTERNET. Accessed 2016 May 16.
  • 7. Roberts JM. Hypertension in Pregnancy. The American Collage of Obstetricians and Gynecologists 2012-2013.
  • 8. English FA, Kenny LC, McCarthy FP. Risk factors and effective management of preeclampsia. Integrated Blood Pressure Control 2015; 8 7-12.
  • 9. Türkiye Halk Sağlığı Kurumu Kadın ve Üreme Sağlığı Dairesi Başkanlığı, Anne Ölümleri 2014. http://www.halksagligi.hacettepe.edu.tr/sunumlar_ve_seminerler/20mart_Sempozyum/Anne_olumleri.pdf [erişim:01.06.2016].
  • 10. Vest AR, Cho LS. Hypertension in pregnancy. Current atherosclerosis reports 2014; 16(3), 1-11.
  • 11. Milne F, Redman C, Walker J, Baker P, Bradley J, Cooper C et all. The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community. Bmj 2005; 330(7491), 576-80.
  • 12. PRECOG: Pre-Eclampsia Community Guideline 2004. http://action-on-pre-eclampsia.org.uk/wp-content/uploads/2012/07/PRECOG-Community-Guideline.pdf. [cited:09.02.2016].
  • 13. Gallos ID, Sivakumar K, Kilby M, Coomarasamy A, Thangaratinam S, Vatish M. Preeeclampsia is associated with, and preceded by, hypertriglyceridaemia: a meta-analysis. BJOG: An International Journal of Obstetrics & Gynaecology 2013; 120(11), 1321-1332.
  • 14. Ozan YD, Ertuğrul M, Okumuş H. Preeklampsi Tanılama, Değerlendirme ve Hemşirelik Yönetimi. Cumhuriyet Hemşirelik Dergisi 2012; 2, 59-65.
  • 15. Spracklen CN, Smith CJ, Saftlas AF, Robinson JG, Ryckman KK. Maternal hyperlipidemia and the risk of preeclampsia: a meta-analysis. American journal of epidemiology 2014; 180(4), 346-358.
  • 16. Swank M, Nageotte M, Hatfield T. Necrotizing pancreatitis associated with severe preeclampsia. Obstetrics & Gynecology 2012; 120, 453-5.
  • 17. Lynch TA, Dexter SC. Alcoholic Pancreatitis Masquerading as Preeclampsia. Obstetrics & Gynecology 2015; 126(6), 1276-8.
  • 18. Ødegård RA, Vatten LJ, Nilsen ST, Salvesen KÅ, Austgulen R. Preeclampsia and fetal growth. Obstetrics & Gynecology 2000; 96(6), 950-5.
  • 19. Townsend NS, Drummond SB. Preeclampsia: Pathophysiology and implications for care. The Journal of perinatal & neonatal nursing 2011; 25(3), 245-52.
  • 20. Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems (Review). Cochrane Database Syst Rev 2014;(6): CD001059.
  • 21. Villar J, Abdel-Aleem H, Merialdi M, Mathai M, Ali MM, Zavaleta N. World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women. American journal of obstetrics and gynecology 2006; 194(3), 639-49.
  • 22. Critchfield AS, Heard AJ. Severe Preeclampsia or Eclampsia and Hypertensive Issues. In: Angelini DJ, LaFontaine D, editors. Obstetric triage and emergency care protocols. New York: Springer Publishing Company; 2012. pp 149-159 .
  • 23. Magee LA, Helewa M, Moutquin J-M, von Dadelszen P, Committee HG. Strategic Training Initiative in Research in the Reproductive Health Sciences (STTRRHS) Scholars." Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy". Journal of obstetrics and gynaecology Canada 2008; 30.
  • 24. Alparslan GB, Akdemir N. Effects of walking and relaxation exercises on controlling hypertension. Journal of the Australian Traditional-Medicine Society 2010; 16(1), 9-15.
  • 25. Endeshaw M, Abebe F, Bedimo M, Asart A. Diet and Pre-eclampsia: A Prospective Multicentre Case–Control Study in Ethiopia. Midwifery 2015; 31(6), 617-24.
  • 26. Hacihasanoğlu R, Gözüm S. The effect of patient education and home monitoring on medication compliance, hypertension management, healthy lifestyle behaviours and BMI in a primary health care setting. Journal of clinical nursing 2011; 20, 692-705.
  • 27. Hypertension in Pregnancy (Report of the ACOG Task Force on Hypertension in Pregnancy) Obstetrics & Gynecology 2013; 122 (5).
  • 28. Stratta P, Canavese C, Porcu M, Dogliani M, Todros T, Garbo E. Vitamin E supplementation in preeclampsia. Gynecologic and obstetric investigation 1994; 37(4), 246-9.
  • 29. Gülmezoğlu AM, Hofmeyr GJ, Oosthuisen MM. Antioxidants in the treatment of severe pre‐eclampsis an explanatory randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology 1997; 104(6), 689-96.
  • 30. Chappell LC, Seed PT, Briley AL, Kelly FJ, Lee R, Hunt BJ. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. The Lancet 1999; 354(9181), 810-6.
  • 31. Roberts JM, Myatt L, Spong CY, Thom EA, Hauth JC, Leveno KJ. Vitamins C and E to prevent complications of pregnancy-associated hypertension. New England Journal of Medicine 2010; 362(14), 1282-91.
  • 32. Xu H, Perez-Cuevas R, Xiong X, Reyes H, Roy C, Julien P. An international trial of antioxidants in the prevention of preeclampsia (INTAPP). American journal of obstetrics and gynecology 2010; 202(3), 239. e1-10.
  • 33. Villar J, Purwar M, Merialdi M, Zavaleta N, Anthony J, De Greeff A. World Health Organisation multicentre randomised trial of supplementation with vitamins C and E among pregnant women at high risk for pre‐eclampsia in populations of low nutritional status from developing countries. BJOG: an International Journal of Obstetrics & Gynaecology 2009; 116(6), 780-8.
  • 34. Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health 2014; (4), 105-145.
  • 35. Wen SW, Champagne J, Rennicks White R, Coyle D, Fraser W, Smith G. Effect of folic acid supplementation in pregnancy on preeclampsia: the folic acid clinical trial study. Journal of pregnancy 2013; ID294312.
  • 36. Abalos E, Duley L, Steyn D, Henderson-Smart D. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy (Review) 2007; (2):CD002252.
  • 37. WHO. Guideline: Calcium supplementation in pregnant women. Geneva, World Health Organization, 2013. http://apps.who.int/iris/bitstream/10665/85120/1/9789241505376_eng.pdf?ua=1 [cited:05.05.2016].
  • 38. Secher NJ, Olsen SF. Fish‐oil and pre‐eclampsia. BJOG: An International Journal of Obstetrics & Gynaecology 1990; 97(12), 1077-9.
  • 39. Sørensen JD, Olsen SF, Pedersen AK, Boris J, Seeher NJ, FitzGerald GA. Effects of fish oil supplementation in the third trimester of pregnancy on prostacyclin and thromboxane production. American journal of obstetrics and gynecology 1993; 168(3), 915-22.
  • 40. Makrides M, Duley L, Olsen SF. Marine oil, and other prostaglandin precursor, supplementation for pregnancy uncomplicated by pre-eclampsia or intrauterine growth restriction. Cochrane Database Syst Rev 2006;(3):CD003402.
  • 41. Villar J, Abalos E, Nardin JM, Merialdi M, Carroli G.Strategies to prevent and treat preeclampsia: evidence from randomized controlled trials. Seminars in nephrology 2004.
  • 42. Olsen SF, Secher NJ, Tabor A, Weber T, Walker JJ, Gluud C. Randomised clinical trials of fish oil supplementation in high risk pregnancies. BJOG: An International Journal of Obstetrics & Gynaecology 2000; 107(3), 382-95.
  • 43. Meher S, Duley L. Nitric oxide for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev 2007;(2): CD006490.
  • 44. Duley L, Henderson-Smart D, Meher S. Altered dietary salt for preventing pre-eclampsia, and its complications. Cochrane Database Syst Rev 2005;(4):CD005548.
  • 45. Briceño-Pérez C, Briceño-Sanabria L, Vigil-De Gracia P. Prediction and prevention of preeclampsia. Hypertension in pregnancy 2009; 28(2), 138-55.
  • 46. Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. The Journal of Clinical Endocrinology & Metabolism 2007; 92(9), 3517-22.
  • 47. Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia. American journal of obstetrics and gynecology 2010; 203(4), 366. e1-6.
  • 48. Shand A, Nassar N, Von Dadelszen P, Inni S, Green T. Maternal vitamin D status in pregnancy and adverse pregnancy outcomes in a group at high risk for pre‐eclampsia. BJOG: An International Journal of Obstetrics & Gynaecology 2010; 117(13), 1593-8.
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There are 66 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Review
Authors

Meltem Uğurlu 0000-0002-9183-219X

Tülay Yavan

Publication Date June 15, 2019
Published in Issue Year 2019 Volume: 50 Issue: 2

Cite

APA Uğurlu, M., & Yavan, T. (2019). Preeklampsi, Maternal ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler ve Hemşirenin Rolü. Zeynep Kamil Tıp Bülteni, 50(2), 75-81. https://doi.org/10.16948/zktipb.358118
AMA Uğurlu M, Yavan T. Preeklampsi, Maternal ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler ve Hemşirenin Rolü. Zeynep Kamil Tıp Bülteni. June 2019;50(2):75-81. doi:10.16948/zktipb.358118
Chicago Uğurlu, Meltem, and Tülay Yavan. “Preeklampsi, Maternal Ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler Ve Hemşirenin Rolü”. Zeynep Kamil Tıp Bülteni 50, no. 2 (June 2019): 75-81. https://doi.org/10.16948/zktipb.358118.
EndNote Uğurlu M, Yavan T (June 1, 2019) Preeklampsi, Maternal ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler ve Hemşirenin Rolü. Zeynep Kamil Tıp Bülteni 50 2 75–81.
IEEE M. Uğurlu and T. Yavan, “Preeklampsi, Maternal ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler ve Hemşirenin Rolü”, Zeynep Kamil Tıp Bülteni, vol. 50, no. 2, pp. 75–81, 2019, doi: 10.16948/zktipb.358118.
ISNAD Uğurlu, Meltem - Yavan, Tülay. “Preeklampsi, Maternal Ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler Ve Hemşirenin Rolü”. Zeynep Kamil Tıp Bülteni 50/2 (June 2019), 75-81. https://doi.org/10.16948/zktipb.358118.
JAMA Uğurlu M, Yavan T. Preeklampsi, Maternal ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler ve Hemşirenin Rolü. Zeynep Kamil Tıp Bülteni. 2019;50:75–81.
MLA Uğurlu, Meltem and Tülay Yavan. “Preeklampsi, Maternal Ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler Ve Hemşirenin Rolü”. Zeynep Kamil Tıp Bülteni, vol. 50, no. 2, 2019, pp. 75-81, doi:10.16948/zktipb.358118.
Vancouver Uğurlu M, Yavan T. Preeklampsi, Maternal ve Fetal Etkileri, Yönetimi Önlenmesine Yönelik Girişimler ve Hemşirenin Rolü. Zeynep Kamil Tıp Bülteni. 2019;50(2):75-81.