NEPHROPATHIES OF PREGNANCY

Our understanding of the pathophysiology underlying the hypertensive d iseases of pregnancy has clearly progressed during the past ten years, The key phenomenon is an early defect of placentation occurring at th e end of the first trimester and associated with a more widespread end othelial disorder. This results in early activation of the coagulation cascade and imbalance between prostacyclin and thromboxanes. Hyperten sion and proteinuria only occur after several weeks or months of place ntal dysfunction. This explains why antihypertensive treatments are in effective in improving the prognosis of such pregnancies. In contrast, early preventive treatments, such as antiplatelet therapy, seem to be very promising for these patients. In this respect, early prediction of the risk associated with pregnancy has become a key goal.