[Hypertension and pregnancy]

Hypertension during pregnancy and its complications are the most important cause of maternal and foetal death and morbidity. The chronic primary hypertension can be differentiated from the dysgravidia by anamnestic, biological, clinical and technical investigations. However the diagnosis remains difficult and the renal needle biopsy can help to ascertain it. The pathogenesis of dysgravidia is still obscure: the placental ischemia leads to a slow disseminated intravascular coagulation state with renal injury, while a vascular hyperreactivity leads to an increase of the resistance, a relative hypovolemia and lowering of cardiac output. The treatment and remote prognosis of the hypertensive disease associated with the pregnancy are summarized. The antihypertensive drugs improve the maternal prognosis while jeopardize the foetal outcome.