Hypertensive disorders of pregnancy

Pre-eclampsia/eclampsia, or pregnancy-induced hypertension, is an uncommon but life-threatening complication of pregnancy associated with significant perinatal morbidity. When superimposed on underlying chronic hypertension, its impact on the fetus becomes even greater. Although the pathophysiology of the disease has not been fully defined, vasospasm appears to be the principal, underlying, etiologic mechanism. Therapy of the disease is principally aimed at controlling convulsions with magnesium sulfate and controlling hypertension with the antihypertensive agent hydralazine. Because development of the disease depends on the presence of trophoblastic tissue, the only true cure for pre-eclampsia/eclampsia is removal of the trophoblast through delivery of the infant. The timing and type of delivery is dependent on the severity of the disease and gestational age of the infant.