[Pregnancy-related hypertension].
OBJECTIVE
Hypertension occurs in 10 to 15 p cent of pregnancies. Among them, 10 to 20% also have proteinuria. This situation defines preeclampsia, and involves a serious threat on fetal and even maternal prognosis. Presence of the hepatic (HELLP) syndrome still severely worsens the prognosis.


BACKGROUND
Pathophysiology of preeclampsia is based on a very early abnormality of placentation, leading to insufficient blood supply to the feto-placental unit. At the maternal level, the main consequence of placental ischemia is generalized endothelial dysfunction, responsible for systemic vasoconstriction and clotting abnormalities. In such a context, lowering blood pressure with drugs is quite inefficient, or even harmful. The prognosis of this disease is mainly related to the pertinence of obstetrical management.


CONCLUSIONS
An early preventive strategy is the most logical approach of preeclampsia, its modalities remain under discussion.
Beaufils
M
M
Service de médecine interne, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France. michel.beaufils@tnn.ap-hop-paris.fr
D000328:Adult; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D015994:Incidence; D010920:Placenta / Q000473:pathology; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D011247:Pregnancy; D011295:Prenatal Care; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology*