Gallery E D
Clin Exp Hypertens B. 1982;1(1):39-47. doi: 10.3109/10641958209037179.
In normal human pregnancy there is considerable expansion of both plasma volume and total extracellular fluid volume, together with marked diminution of vascular reactivity in response to intravenous infusion of vasopressor agents. Pregnancy-associated hypertension (pre-eclampsia) is characterised by increased vascular reactivity, vasoconstriction and a fall in plasma volume associated with a shift of fluid from intravascular to interstitial fluid space. Direct expansion of plasma volume in patients with pregnancy-associated hypertension leads to partial correction of the abnormalities of volume homeostasis together with a significant fall in blood pressure. Certain forms of antihypertensive therapy also lead to reversal of volume contraction and improvement in cardiac function. This is associated with lowered vascular resistance and improved placental function, leading to improved pregnancy outcome. Although these observations do not elucidate the ultimate cause/causes of pregnancy-associated hypertension, they help to unravel the pathologic mechanisms by which the syndrome causes its effects and to suggest rational paths by which therapeutic endeavours may be expected to benefit mother and fetus.
在正常人类妊娠过程中，血浆容量和细胞外液总量会显著增加，同时静脉输注血管加压药时血管反应性会明显降低。妊娠相关高血压（先兆子痫）的特征是血管反应性增加、血管收缩以及血浆容量下降，伴有液体从血管内转移至组织间隙。对妊娠相关高血压患者直接扩充血浆容量可部分纠正容量稳态异常，并使血压显著下降。某些形式的抗高血压治疗也会导致容量收缩的逆转及心脏功能改善。这与血管阻力降低和胎盘功能改善相关，从而改善妊娠结局。尽管这些观察结果并未阐明妊娠相关高血压的最终病因，但它们有助于揭示该综合征产生影响的病理机制，并为有望使母亲和胎儿受益的治疗努力指明合理途径。
