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Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 16))

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Abstract

The most dramatic manifestation of hypertension in pregnancy is the development of eclampsia, the premonitory signs and clinical manifestations of which have been documented in the medical literature since the time of Hippocrates [1]. However, eclampsia represents a very small and extreme section of hypertension in pregnancy and by far the commonest situation is the development of mild hypertension, with or without the presence of proteinuria, in the third trimester of pregnancy. In its severe forms, hypertension in pregnancy is associated with a significant risk to maternal and foetal life. In its mildest form, arising in late pregnancy for the first time, hypertension appears to be associated with no significant maternal hazard and improved foetal growth and survival [2, 3].

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References

  1. The Medical Works of Hippocrates. Translated by Adams F, p. 715. London: The Sydenham Society, 1849.

    Google Scholar 

  2. Symonds EM: Hypertension in pregnancy. In: Recent Advances in Obstetrics and Gynaecology, p. 167. Stallworthy j, Bourne G, eds. Edinburgh: Churchill Livingstone, 1979.

    Google Scholar 

  3. Clinch J: Late pregnancy hypertension - a harmless condition. J Ir Med Assoc 73: 348, 1980.

    CAS  Google Scholar 

  4. Page EW, Christianson R: The impact of mean arterial pressure in the middle trimester upon the outcome of pregnancy. Am J Obstet Gynecol 125: 740–745, 1976.

    PubMed  CAS  Google Scholar 

  5. MacGillivray I: Pre-eclampsia in Great Britain and Ireland. Pathol Microbiol 24: 504, 1981.

    Google Scholar 

  6. Page EW: On the pathogenesis of pre-eclampsia and eclampsia. J Obstet Gynaecol Br Commonw 79: 863–894, 1972.

    Article  Google Scholar 

  7. Zuspan FP, Nelson GH, Ahelquist RP: Epinephrine infusions in normal and toxemic pregnancy - I. Nonesterified fatty acids and cardiovascular alterations. Am J Obstet Gynecol 90: 88–96, 1964.

    PubMed  CAS  Google Scholar 

  8. Talledo OE, Chesley LC, Zuspan FP: Renin-angiotensin system in normal and toxemic pregnancies - III. Differential sensitivity to angiotensin II and norepinephrine in toxemia of pregnancy. Am J Obstet Gynecol 100: 218 - 221, 1968.

    Google Scholar 

  9. Chesley LC, Valenti C: The evaluation of tests to differentiate pre-eclampsia from hypertensive disease. Am J Obstet Gynecol 75: 1165–1173, 1958.

    PubMed  CAS  Google Scholar 

  10. Talledo OE: Renin-angiotensin system in normal and toxemic pregnancies - I. Angiotensin infusion test. Am J Obstet Gynecol 96: 141–143, 1966.

    PubMed  CAS  Google Scholar 

  11. Gant NF, Daly GL, Chand S, Whalley PJ, MacDonald PC: A study of angiotensin II pressor response throughout primigravid pregnancy. J Clin Invest 52: 2682–2689, 1973.

    Article  PubMed  CAS  Google Scholar 

  12. Weir RJ, Brown JJ, Fräser R et al.: Relationship between plasma renin, renin-substrate, angiotensin II, aldosterone and electrolytes in normal pregnancy. J Clin Endocrinal Metab 40: 108, 1975.

    Article  CAS  Google Scholar 

  13. Skinner SL, Lumbers ER, Symonds EM: Analysis of changes in the renin-angiotensin system during pregnancy. Clin Sci 42: 479, 1972.

    PubMed  CAS  Google Scholar 

  14. Gordon RD, Symonds EM, Wilmshurst EG, Pawsey CGK: Plasma renin activity, plasma angiotensin and plasma and urinary electrolytes in normal and toxaemic pregnancy including a prospective study. Clin Sci Mol Med 45: 115, 1973.

    CAS  Google Scholar 

  15. Lammintausta R, Erkkola R: Renin-angiotensin aldosterone system and sodium in normal pregnancy. A Longitudinal study. Acta Obstet Gynecol Scand 56: 221, 1977.

    PubMed  CAS  Google Scholar 

  16. Skinner SL, Cran EJ, Gibson R et al.: Angiotensins I and II, active and inactive renin, renin substrate, renin activity and angiotensinase in human liquor amnii and plasma. Am J Obstet Gynecol 121: 626, 1975.

    PubMed  CAS  Google Scholar 

  17. Symonds EM, Andersen GJ: The effect of bed rest on plasma renin in hypertensive disease of pregnancy. J Obstet Gynaecol Br Commonw 81: 676, 1974.

    Article  PubMed  CAS  Google Scholar 

  18. Weir RJ, Brown JJ, Fräser R et al.: Plasma renin, renin-substrate, angiotensin II and aldosterone in hypertensive disease of pregnancy. Lancet 1: 291, 1973.

    Article  PubMed  CAS  Google Scholar 

  19. Kokot F, Cekanski A: Plasma renin activity in peripheral and uterine vein blood in pregnant and non-pregnant women. J Obstet gynaecol Br Commonw 79: 72, 1972.

    Article  PubMed  CAS  Google Scholar 

  20. Symonds EM, Broughton Pipkin F, Craven DJ: Changes in the renin-angiotensin system in Primigravidae with hypertensive disease of pregnancy. Br J Obstet Gynaecol 82: 643, 1975.

    Article  PubMed  CAS  Google Scholar 

  21. Broughton Pipkin F, Symonds EM: Angiotensin II and the placenta in normal pregnancy and pregnancy complicated by hypertension. J Physiol 256: 121, 1975.

    Google Scholar 

  22. Sperof TL, Dorfman GS: Prostaglandins and pregnancy hypertension. Clin Obstet Gynaecol 4:635. London: Saunders, 1977.

    Google Scholar 

  23. O’Brien PMS, Filshie GM, Broughton Pipkin F: The effect of Prostaglandin E2 on the cardiovascular response to angiotensin II in pregnant rabbits. Prostaglandins 113: 171, 1977.

    Article  Google Scholar 

  24. O’Brien PMS, Broughton Pipkin F: The effects of deprivation of prostaglandin precursors on vascular sensitivity to angiotensin II and on the kidney in the pregnant rabbit. Br J Pharmacol 65: 29, 1979.

    PubMed  Google Scholar 

  25. Speroff L: An autoregulatory role for prostaglandins in placental hemodynamics. Their possible influence on blood pressure in pregnancy. J Reprod Med 15: 181, 1975.

    PubMed  CAS  Google Scholar 

  26. Schmorl G: Pathologisch-anatomische Untersuchungen über Puerperal-Eklampsie. Leipzig: Vogel, 1893.

    Google Scholar 

  27. McKay DG, Merrill SJ, Weiner AE, Hertig AT, Reid DE: The pathologic anatomy of eclampsia, bilateral renal cortical necrosis, pituitary necrosis and other acute fatal complications of pregnancy, and its possible relation to the generalised Schwartzman phenomenon. Am J Obstet Gynecol 66: 507, 1953.

    PubMed  CAS  Google Scholar 

  28. Chesley LC: In: Hypertensive Disorders in Pregnancy, p. 105. New York: Appleton-Century-Crofts, 1978.

    Google Scholar 

  29. Pritchard JA, Cunningham FG, Mason RA: Coagulation changes in eclampsia: their frequency and pathogenesis. Am J Obstet Gynecol 124: 855, 1976.

    PubMed  CAS  Google Scholar 

  30. Hyde E, Joyce D, Gurewich V, Flute PT, Barrera S: Intravascular coagulation during pregnancy and the puerperium. J Obstet Gynaecol Br Commonw 80: 1059, 1973.

    Article  PubMed  CAS  Google Scholar 

  31. Sheehan HL, Lynch JB: In: Pathology of Toxaemia of Pregnancy. London: Churchill Livingstone, 1973.

    Google Scholar 

  32. McKay DG: Clinical significance of the pathology of toxaemia of pregnancy. Circulation 30 (Suppl 2): 66–75, 1964.

    PubMed  Google Scholar 

  33. Jaameri KEU, Koivuniemi AP, Carpen EO: Occurence of trophoblasts in the blood of toxaemic patients. Gynaecologia 160: 315, 1965.

    PubMed  CAS  Google Scholar 

  34. McKay DG, Goldenberg V, Kaunitz H, Csavossy I: Experimental eclampsia: an electron microscope study and review. Arch Pathol 84: 1557, 1967,

    Google Scholar 

  35. Chesley LC: In: Hypertensive disorders in Pregnancy, p. 467. New York: Appleton-Century-Crofts, 1978.

    Google Scholar 

  36. Carretti N, Chiaramonte P, Pasini C, Zanetti M, Fagiolo U: Association of anti-HL-A antibodies with toxemia in pregnancy. In: First International Symposium on Immunology in Obstetrics and Gynaecology, Amsterdam, p. 221. Centaro A, Carretti N, eds. Amsterdam: Excerpta Medica, 1974.

    Google Scholar 

  37. Scott JR, Beer AE, Stastny P: Immunogenetic factors in pre-eclampsia and eclampsia. Erythrocyte, histocompatibility and Y-dependent antigens. JAMA 235: 402, 1976.

    Article  PubMed  CAS  Google Scholar 

  38. Yang SL, Kleinman AM, Wei PJ: Immunologic aspects of term pregnancy toxemia: study of immunoglobulins and complement. Am J Obstet Gynecol 122: 727, 1975.

    PubMed  CAS  Google Scholar 

  39. Burdash NM, Blake JM Jr, Hester LI Jr: Immunoglobulin levels and liver function tests in normal and toxemic pregnancies. Am J Obstet Gynecol 116: 827, 1973.

    PubMed  CAS  Google Scholar 

  40. Petrucco OM, Thomson NM, Lawrence JR, Weldon MW: Immunofluorescent studies in renal biopsies in pre-eclampsia. Br Med J 473, 1974.

    Google Scholar 

  41. Spargo BH, Lichtig C, Luger AM, Katz AI, Lindheimer MD: The renal lesion in pre-eclampsia: examination by light and electron and immunofluorescence microscopy. In: Hypertension in Pregnancy, p. 129. Lindheimer MD, Katz AI, Zuspan FP, eds. New York: J. Willey & Sons, 1976.

    Google Scholar 

  42. Chesley LC: In: Hypertensive Disorders in Pregnancy, p. 309. New York: Appleton-Century-Crofts, 1978.

    Google Scholar 

  43. Hamlin RHJ: The prevention of eclampsia and pre-eclampsia. Lancet 1: 64, 1952.

    Article  PubMed  CAS  Google Scholar 

  44. Matthews DD: A randomized controlled trial of bed rest and sedation on normal activity and non-sedation in the management of non-albuminuric hypertension in late pregnancy. Brit J Obstet Gynaecol 84: 108, 1977.

    Article  Google Scholar 

  45. Chamberlain GVP, Lewis PJ, De Swiet M, Bulfitt CJ: How obstetricians manage hypertension in pregnancy. Brit Med J 1: 626, 1978.

    Article  PubMed  CAS  Google Scholar 

  46. Campbell DM, MacGillivray I: The effect of a low calorie diet or a thiazide diuretic on the incidence of pre-eclampsia and on low birth weight. Br J Obstet Gynaecol 82: 572, 1975.

    Article  PubMed  CAS  Google Scholar 

  47. Redman CWG, Beilin U, Bonnar J: Fetal outcome in trial of antihypertensive treatment in pregnancy. Lancet 2: 753, 1976.

    Article  PubMed  CAS  Google Scholar 

  48. Rudolph AN, Heyman MA: Foetal and Neonatal Physiology. Rudolph AN, Heyman MA, eds. Cambridge: Cambridge University Press, 1973.

    Google Scholar 

  49. Lieberman BA, Stirrat GM, Cohen SL, Beard RW, Pinker GD, Selsey E: The possible adverse effects of propanalol on the foetus in pregnancies complicated by severe hypertension. Br J Obstet Gynaecol 85: 678, 1978.

    Article  PubMed  CAS  Google Scholar 

  50. Eliahou HE, Silverberg DS, Reisin E, Romem J, Mashiachi S, Serr DM: Propanalol for the treatment of hypertension in pregnancy. Br J Obstet Gynaecol 85: 431, 1978.

    Article  PubMed  CAS  Google Scholar 

  51. Gallery EDM, Saunders DM, Hungor SN, Gyory AZ: Randomised comparison of methyl dopa and Oxprenolol for the treatment of hypertension in pregnancy. Br Med J 1: 1591, 1979.

    Article  PubMed  CAS  Google Scholar 

  52. Bott-Kanner G, Schweitzner A, Reisner SH, Joel-Cohen SJ, Rosenfeld JB: Propanolol and hydralazine in the management of essential hypertension in pregnancy. Br J Obstet Gynaecol 87: 110, 1980.

    Article  PubMed  CAS  Google Scholar 

  53. Lamming GD, Broughton Pipkin F, Symonds EM: Comparison of the alpha and beta blocking drug labetalol and methyl dopa in the treatment of moderate and severe pregnancy-induced hypertension. Clin Exp Hypertension 2: 865, 1980.

    Article  CAS  Google Scholar 

  54. Pritchard ja: Standardised treatment of 154 consecutive cases of eclampsia. Am J Obstet Gynecol 123: 543, 1975.

    PubMed  CAS  Google Scholar 

  55. Adams JH, Mitchell JRA: The effect of agents which modify platelet behaviour and of magnesium ions on thrombus formation in vivo. Thromb Haemostas 42: 603, 1979.

    CAS  Google Scholar 

  56. Duffus GM, Tunstall ME, Condie RG, MacGillivray I: Chlormethiazole in the prevention of eclampsia and the reduction of perinatal mortality. J Obstet Gynaecol Br Commonw 76: 645, 1969.

    Article  PubMed  CAS  Google Scholar 

  57. Brinkman CR, Assali NS: Uteroplacental hemodynamic response to antihypertensive drugs in hypertensive pregnant sheep. In: Hypertension in Pregnancy, p. 363. Lindheimer MD, Katz AI, Zuspan FP, eds. New York: J Wiley & Sons, 1976.

    Google Scholar 

  58. Bonnar J: Coagulation disorders. J Clin Path 29 (Suppl 10): 35, 1976.

    Article  Google Scholar 

  59. Howie PW, Prentice CRM, McNicol GP: Failure of heparin therapy to affect the clinical course of severe pre-eclampsia. Br J Obstet Gynaecol 82: 711, 1975.

    Article  PubMed  CAS  Google Scholar 

  60. Kincaid-Smith P, Bullen M, Mills J: Prolonged use of methyl dopa in severe hypertension in pregnancy. Br Med J 1: 274, 1966.

    Article  PubMed  CAS  Google Scholar 

  61. Leather HM, Humphreys DM, Baker P, Chadd MA: A controlled trial of hypertensive agents in hypertension in pregnancy. Lancet 2: 488, 1968.

    Article  PubMed  CAS  Google Scholar 

  62. Chesley LC. In: Hypertensive Disorders in pregnancy, p. 482. New York: Appleton-Century-Crofts, 1978.

    Google Scholar 

  63. Ferris TF: Renal disease. In: Medical Complications during Pregnancy, p. 20. Burrow GN, Ferris TF, eds. Philadelphia: Saunders, 1975.

    Google Scholar 

  64. Felding C: Obstetric aspects in women with histories of renal disease. Acta Obstet Gynecol Scand 48 (Suppl2): 1, 1969.

    Article  PubMed  Google Scholar 

  65. Budman DR, Steinberg Ad: Hypertension and renal disease in systemic lupus erythematosis. Arch Intern Med 136: 1003, 1976.

    Article  PubMed  CAS  Google Scholar 

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© 1982 Martinus Nijhoff Publishers, The Hague

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Symonds, E.M. (1982). Hypertension in Pregnancy. In: Amery, A., Fagard, R., Lijnen, P., Staessen, J. (eds) Hypertensive Cardiovascular Disease: Pathophysiology and Treatment. Developments in Cardiovascular Medicine, vol 16. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-7476-0_39

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  • DOI: https://doi.org/10.1007/978-94-009-7476-0_39

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-009-7478-4

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