Fortnightly Review: The hypertensive disorders of pregnancy

Abstract

#### Summary points The hypertensive disorders of pregnancy remain an enigma. Biologically speaking, pregnancy is the time when women are the most important to the species. One feels instinctively that any condition that occurs in between 1 in 7 and 1 in 10 women during the course of their first pregnancy cannot be all bad. And yet, successive reports on confidential inquiries into maternal deaths in the United Kingdom have identified hypertension in pregnancy as the most frequently cited cause of maternal death. I cannot cover the pathophysiology of eclampsia in this brief review. Eclampsia occurs unexpectedly in about one in 2000 maternities in the United Kingdom1 and is therefore difficult to study systematically. More than one third of cases occur before the classic warning signs of both proteinuria and hypertension have been documented, and …