Summary
Hypertension may occur during pregnancy because of either toxaemia or hypertension without evidence of renal involvement. Toxaemia is a multisystem disease, typically occurring in late pregnancy, with hypertension, proteinuria, oedema, and central nervous system irritability. Since convulsions may occur with severe toxaemia, the disease has been divided into eclampsia and pre-eclampsia, based on whether a seizure has occurred. Toxaemia accounts for approximately 70% of hypertension seen in pregnant women.
As there is evidence that PGI2 synthesis increases in blood vessels and PGE2 synthesis increases in the uterus and kidneys during pregnancy, a reduction in prostaglandin synthesis may occur with toxaemia. It may be that a derangement in the proportion of PGI2 in blood vessels and thromboxane synthesis in platelets could lead to aggregation. This in turn could cause fibrin deposits in the central nervous system, kidneys and liver, as well as a consumptive coagulopathy, in severe toxaemia.
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Ferris, T.F. The Pathophysiology of Toxaemia and Hypertension during Pregnancy. Drugs 25 (Suppl 2), 198–205 (1983). https://doi.org/10.2165/00003495-198300252-00059
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DOI: https://doi.org/10.2165/00003495-198300252-00059