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[Arterial hypertension of the pregnant woman]
1Service de Médecine Interne A, Hôpital Tenon, Paris.
Pregnancy hypertension remains a frequent disease, sometimes seriously threatening mother and fetus. Its primum movens has been shown to be an abnormal placentation and/or trophoblastic invasion. This abnormality is triggered by various factors which can be immunologic, vascular, or abnormalities of hemostasis. This defective placentation results in a systemic endothelial disease with vasoconstriction and widespread thrombotic tendency. Antihypertensive treatment is of very poor efficiency, and even may worsen the fetal situation through underperfusion. Early prevention is clearly a better way to improve the prognosis. Low-dose aspirin is widely used, although its efficiency has been debated recently, after the publication of negative results. It is likely that proper selection of patients, as well as the timing and dosage of treatment, are key factors for its efficiency.
Pregnancy hypertension remains a frequent disease, sometimes seriously threatening mother and fetus. Its primum movens has been shown to be an abnormal placentation and/or trophoblastic invasion. This abnormality is triggered by various factors which can be immunologic, vascular, or abnormalities of hemostasis. This defective placentation results in a systemic endothelial disease with vasoconstriction and widespread thrombotic tendency. Antihypertensive treatment is of very poor efficiency, and even may worsen the fetal situation through underperfusion. Early prevention is clearly a better way to improve the prognosis. Low-dose aspirin is widely used, although its efficiency has been debated recently, after the publication of negative results. It is likely that proper selection of patients, as well as the timing and dosage of treatment, are key factors for its efficiency.