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A Journal on Internal Medicine

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Minerva Medica 2006 August;97(4):347-64

language: English

Pathophysiology and medical management of systemic hypertension and pre-eclampsia in pregnancy

Frishman W. H. 1, Veresh M. 1, Schlocker S. J. 2, Tejani N. 3

1 Department of Medicine New York Medical College/ Westchester Medical Center, Valhalla, NY, USA
2 Department of Internal Medicine Scripps-Mercy Hospital, San Diego, CA, USA
3 Department of Obstetrics and Gynecology New York Medical College/ Westchester Medical Center, Valhalla, NY, USA


Hypertension in pregnancy includes a group of distinct disorders that require special consideration in both prevention and pharmacological treatment. In recent years, there have been few advances regarding the pathophysiology and prevention of pre-eclampsia, however there have been some promising studies regarding possible modes of screening women for preeclampsia before clinical signs and symptoms are apparent. The recommendations for first-line drug therapy for the hypertensive complications of pre-eclampsia, and the recommendations for pharmacological treatment of women with chronic hypertension antedating pregnancy, have changed little primarily because first-line medications have the advantage of having had more extensive research experience. Recent clinical trials have demonstrated the efficacy and safety of various second-line drugs for the hypertensive disorders of pregnancy; whether these therapies can eventually replace the standard recommended medications will require more extensive long-term investigation.

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