The haemodynamic pathophysiology of pre-eclampsia

Pre-eclampsia and 'essential' hypertension in pregnancy require to be studied separately. Their haemodynamic characteristics need to be determined and the effects of antihypertensive therapy and blood volume expansion explored. Diuretics should be used in pre-eclampsia only to treat cardiac failure. Hydrallazine may be contraindicated if cardiac failure is imminent. The role of propranolol remains undecided and a controlled trial is required. Studies of the renin-angiotensin system which take into account the various factors that alter renin secretion may prove useful.