Preeclampsia: New Thoughts on an Ancient Problem

Preeclampsia is a hypertensive disorder unique to pregnancy and is of unknown cause. It is both a maternal as well as fetal syndrome. It affects 2%-10% of nulliparas, and is more prevalent when preexisting hypertension, renal disease, or diabetes is present. The main clinical features of the disorder are maternal hypertension, proteinuria, and abnormal renal, hepatic, and central nervous system function. The fetal syndrome includes growth restriction, intrauterine death, and premature delivery. Abnormalities in the development of the placental circulation are believed to be important causal features of the pathogensis of preeclampsia and are present early in pregnancy. The link between the placental disease and the maternal syndrome remains mysterious. Clinical trials of low dose aspirin and calcium in the prevention of preeclampsia have not demonstrated significant benefits of treatment. The current approach to treatment is close monitoring of maternal and fetal health, bed rest, judicious use of antihypertensive therapy to prevent maternal complications, and seizure prophylaxis with magnesium sulfate. (c)2000 by Le Jacq Communications, Inc.