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Hypertonie und Schwangerschaft [Hypertension and pregnancy]

Item Type:Article
Title:Hypertonie und Schwangerschaft [Hypertension and pregnancy]
Creators Name:Homuth, V. and Derer, W. and Dechend, R.
Abstract:Hypertensive disorders complicate pregnancy in more than 10 % worldwide. Generally several forms were differentiated from one another. Especially pre-eclampsia, namely hypertension and proteinuria after the 20th week of gestation, is the most common cause of maternal and fetal mortality and morbidity. Their aetiology is unknown. Because elective delivery remains the only effective management approach, the main complication is neonatal death due to prematurity. Now we do not have sufficient evidence to know when to begin antihypertensive treatment, how vigorously to treat, or whether to stop treatment in mild chronic hypertension and hope that the hypotensive effect of normal pregnancy will be enough to control blood pressure. In several studies treatment of hypertension in pregnancy resulted in an increased risk of growth restriction in their infants. These results and the unknown long-term effects on the infant of any treatment led to current recommendations to treat only blood pressure elevations with a potential acute risk for the mother. Only less antihypertensive drugs are available which can be used in pregnancy. The only trial for treatment of hypertension during pregnancy with adequate infant follow-up was performed over 30 years ago with alpha-methyldopa, the antihypertensive drug of choice in pregnancy as yet. Epidemiological data indicate that women with preeclampsia are more likely to develop cardiovascular disease (e. g. myocardial infarction, stroke) later in life, compared with normotensive pregnancy. Many risk factors are shared by cardiovascular diseases and preeclampsia, including endothelial dysfunction, obesity, hypertension, hyperglycemia, insulin resistance, and dyslipidemia. Therefore, it has been proposed that the metabolic syndrome may be a possible underlying mechanism. A lifelong follow-up and counselling of women with a history of preeclampsia may be an opportunity for prevention of future disease.
Keywords:Hypertension, Preeclampsia, Cardiovascular Risk
Source:Deutsche Medizinische Wochenschrift
Page Range:195-200
Date:January 2009
Official Publication:https://doi.org/10.1055/s-0028-1123978
PubMed:View item in PubMed

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