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  • Title: Hypertensive disease in pregnancy.
    Author: Dekker GA, van Geijn HP.
    Journal: Curr Opin Obstet Gynecol; 1992 Feb; 4(1):10-27. PubMed ID: 1543821.
    Abstract:
    The possible involvement of genetic and immune mechanisms in the etiology of preeclampsia has attracted increasing attention. Preeclampsia is characterized by a generalized disturbance in endothelial physiology, and not merely by an isolated defect in vascular prostacyclin synthesis. The increased production of oxygen-free radicals, elastase, or both by activated lymphoid cells in the pregnant decidua, a mainly lymphoid tissue, may be the link between the hypothetical immunologic mechanisms and the endothelial injury occurring in preeclampsia. New treatment protocols emphasize timely referral to a perinatal center to obtain optimal maternal and perinatal care. Intensive fetal and maternal monitoring are of vital importance. Optimal management usually involves balancing risks of expectant management for mother and fetus against the risk of extreme prematurity from immediate delivery.
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