[Late gestosis as a compensation mechanism in fetal growth retardation and its disruption by antihypertensive therapy].
A study of the clinical course of severe pre-eclamptic toxemias shows that, in case of antihypertensive therapy, it is usually necessary to terminate the pregnancy in cases of foetal maldevelopment, in cases with foetal indication (if no intrauterine death of the foetus takes place), whereas if there is no maldevelopment it is usually a maternal indication that enforces before-term termination of pregnancy. In case of foetal maldevelopment, a drop in HPL and oestriol values was seen. This suggests that the foetal condition deteriorates under antihypertensive treatment. For the foetus, which is deficiently supplied by the placenta, pre-eclamptic toxaemia is a regulatory mechanism of circulation that enhances blood supply of the placenta, since the peripheral resistance in the placental circulation, which is free from vascular nerves, is lower than in the nerve-supplied circulation of the body, on which a hypertensive substance can act. The assumption that such a compensatory mechanism exists is supported by a number of clinical observations. This regulation, which is necessary for the development and perhaps also for the survival of the foetus, is disturbed by the antihypertensive therapy, which explains the deterioration in the condition of the foetus.
Warkentin
B
B
Gynäkologisch-geburtshilfliche Abteilung am Städtischen Krankenhaus Lörrach.
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001238:Asphyxia Neonatorum / Q000503:physiopathology; D002585:Cesarean Section; D004359:Drug Therapy, Combination; D004964:Estriol / Q000097:blood; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000187:drug effects*; D010928:Placental Lactogen / Q000097:blood; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy
D000959:Antihypertensive Agents; D010928:Placental Lactogen; D004964:Estriol
Die Spätgestose als Kompensations-Mechanismus bei fetaler Mangelentwicklung und seine Störung durch blutdrucksenkende Therapie.