Hypertension and pregnancy: physiopathology, treatment, prevention
Beaufils, M.; Uzan, S.
La Revue du Praticien 43(15): 1973-1978
1993
ISSN/ISBN: 0035-2640 PMID: 8310255 Document Number: 416605
Pathophysiologic understanding of the hypertensive diseases of pregnancy has largely progressed in the past 10 years. The key phenomenon is an early defect of placentation, occurring at the end of first trimester. It is associated with a more global endothelial disorder. This results in early activation of coagulation, and an imbalance between prostacyclin and thromboxanes. Hypertension and proteinuria only occur after several weeks or months of placental dysfunction. This explains why antihypertensive treatments are ineffective in improving the prognosis of such pregnancies. On the contrary, early preventive treatments, such as antiplatelet therapy, seem very promising for those patients.