Open AccessPre‐Eclampsia: A Hypothesis for its Pathogenesis
Author(s) -
Enhorning Goran
Publication year - 1984
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016348409157115
Subject(s) - medicine , pathogenesis , pregnancy , reabsorption , venous return curve , renal function , endocrinology , blood pressure , renal blood flow , uterus , renal sodium reabsorption , kidney , hemodynamics , biology , genetics
. A hypothesis is presented according to which the pathogenesis of pregnancy‐induced hypertension can be attributed to disturbances in renal function caused by the upright posture of the human. In pregnancy, glomerular filtration rate (GFR) and tubular reabsorption, the latter stimulated by aldosterone, are working in high gear. A diminished GFR with continued stimulation of tubular re‐absorption would lead to sodium retention. That situation could result, particularly in the primigravida, from the enlarged uterus of late pregnancy exerting pressure on and interfering with venous return, arterial blood flow to kidneys, and/or ability of ureters to transport urine and maintain low pressure in the kidney pelvis. At an early stage, pre‐eclampsia can be controlled by bed rest, quite likely by removing dangerous uterine compression. Animal studies are required to test the hypothesis.