The pathogenesis of eclampsia: the 'magnesium ischaemia' hypothesis.
'Magnesium ischaemia' is a term used to denote the functional impairment of the ATP-dependent sodium/potassium and calcium pumps in the cell membranes and within the cell itself. The production of ATP and the functioning of these pumps is magnesium-dependent and is critically sensitive to acidosis. Zinc and iron deficiencies may secondarily impair these pumps and thus contribute to 'magnesium ischaemia' (as does acidosis). This term is two-dimensional at its simplest; it refers to a functional magnesium deficiency, whether actual or induced. It is argued that chronic acidosis is the most common inducing factor. This simple hypothesis can begin to unify diverse pathophysiologies: some spontaneous abortions, aspects of Type II and gestational diabetes and the curious observation that heroin addicts become diabetic. It can also unify clinical thinking about pregnancy-induced hypertension, pre-eclampsia/eclampsia and acute fatty liver of pregnancy, as well as the coagulopathy of pregnancy. It makes important predictions about perinatal morbidity and suggests that early supplementation might prevent much pregnancy-induced disease.
Department of Obstetrics, Shellharbour Hospital, Illawara Area Health Service, NSW, Australia.
J C
JC
Newman
J L
JL
Amarasingham
D000252:Calcium-Transporting ATPases / Q000378:metabolism / Q000502:physiology; D004461:Eclampsia / Q000503:physiopathology*; D005260:Female; D006706:Homeostasis; D006801:Humans; D008274:Magnesium / Q000378:metabolism*; D008275:Magnesium Deficiency / Q000503:physiopathology*; D008954:Models, Biological; D011247:Pregnancy / Q000502:physiology*; D000254:Sodium-Potassium-Exchanging ATPase / Q000378:metabolism / Q000502:physiology
D000252:Calcium-Transporting ATPases; D000254:Sodium-Potassium-Exchanging ATPase; D008274:Magnesium