The Relevance of Hypertension and Oedema in Pregnancy

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Abstract
The triad of severe preeclampsia is often described as a combination of hypertension, edema and proteinuria. Hypertension alone arising in the 2nd half of pregnancy is not associated with any greater perinatal mortality or birthweight than normotensive primigravidae; this hypertension may be physiological or a manifestation of essential hypertension or, in some cases, a mild form of preeclampsia. Edema does not necessarily signify abnormality. High weight gain, fluid retention or edema is associated with a lower incidence of small babies but with a higher incidence of preeclampsia. Considerable amounts of water retention can occur in normal pregnancy, measured as an increase during pregnancy or as a fall after delivery. The diuretics cyclopenthiazide, spironolactone and clopamide given prophylactically to high weight gain primigravidae did not prevent the onset of proteinuric preeclampsia, but caused the babies to be lighter in weight than those of controls. Na, K and water content of leukocytes from primigravida [women] with proteinuric preeclampsia is the same as in mild preeclampsia and normal pregnancy. Although salt and water retention are common features of preeclampsia, they do not cause the condition and are not an essential part of it.