Prevention of Hypertensive Disorders in Pregnancy

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Abstract
For unknown reasons some women fail to exhibit or maintain proper adaptational circulatory responses to the presence of trophoblast, which may lead to circulatory maladaptation disease (“MAD-disease”). Pregnancy-induced hypertension (PIH) and preeclampsia (PE), and also fetal growth retardation, abruptio placentae, and premature labor may represent clinical expressions of MAD-disease. So far, primary prevention of PIH-PE appears to be not possible, except by means of avoiding pregnancy altogether. However, secondary prevention may be feasible by manipulation of the eicosanoid (prostaglandin) system, a disturbance of which has emerged as an important secondary mechanism in the development of PIH-PE. Results of small controlled studies on secondary prevention of PIH-PE and of other expressions of MAD-disease using low-dose aspirin look promising, but application in clinical practice should await the outcome of larger properly designed clinical trials.

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