Gestational arterial hypertension
Introduction
Some risk factors for the development of gestational hypertension have been recognized. Some of these factors are related to the development of chorionic villi among which exposure to these villi are more frequently found in very young or very adult primiparous women or those who were overexposed to villi as in the hydatidiform cool and theMultiparity. Other risk factors are in relation to endothelial alterations that can be caused for example by diabetes or chronic kidney disease. Other risk factors are obesity and genetic alterations such as antiphospholipid or thrombus syndrome, and genetic predisposition to arterial hypertension.
Developing
It is striking that smoking is associated with a risk reduction to develop hypertension during pregnancy. Although a proven cause has not been obtained from gestational hypertension, some theories that explain their possible etiology have developed, one of them explains gestational hypertension due to an anomalous trophoblastic invasion of the uterine vessels. Another theory indicates that the cause would be anomalous adaptation between maternal, fetal and placental tissues. Endothelium has also been studied as a possible etiology of gestational hypertension. Other factors can be:
- Genetic maternal predisposition
- Nutritional factors
- Pathophysiology
- Vascular changes
Naturally, during pregnancy there is physiological hypervolemia can be altered in women with preeclampsia or eclampsia that results in hemoconcentration. Another change of importance is the spasm vessel product of interaction of different vasoactive agents such as endothelins, thromboxans and prostacicclines, among others. Some studies conducted in order to find a therapeutic solution were carried out using fluid therapy as a means to reverse hemoconcentration (Hypertension and Preecl Heloconcentration). However, this was counterproductive.
It was even risky due to capillary leakage and decreased plasma oncotic pressure associated with preeclampsia, so that aggressive therapy fluids can increase the pulmonary capillary interlock pressure and predispose to pulmonary edema. The alteration of liver enzymes in women with preeclampsia is frequent. The aminotransferase (AST) aspartate is a hepatic enzyme that is related to liver dysfunction by peri -portal necrosis and is also the dominant transaminase during pre eclampsia, an importance of importance that can guide us to diagnosis.
conclusion
Especially during the early stages, being a fact that helps distinguish pre -ecompsia from other causes of transaminase elevation, in which usually, it is the aminotransferase Alanine (ALT) the enzyme that predominates in the first stages of pathology. Another transaminase that can be high is the dehydrogenase lactate (LDH) that can be altered by ischemic and necrotic changes in liver tissue, as well as freeing the bloodstream during hemolysis. Hepatic dysfunction can also alter coagulation times, raising prothrombin time (TP), partial thromboplastin time.
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