THE PATHOGENESIS OF ECLAMPSIA - THE MAGNESIUM ISCHEMIA HYPOTHESIS

'Magnesium ischaemia' is a term used to denote the functional impairme nt of the ATP-dependent sodium/potassium and calcium pumps in the cell membranes and within the cell itself. The production of ATP and the f unctioning of these pumps is magnesium-dependent and is critically sen sitive to acidosis. Zinc and iron deficiencies may secondarily impair these pumps and thus contribute to 'magnesium ischaemia' (as does acid osis). This term is two-dimensional at its simplest; it refers to a fu nctional magnesium deficiency, whether actual or induced. It is argued that chronic acidosis is the most common inducing factor. This simple hypothesis can begin to unify diverse pathophysiologies: some spontan eous abortions, aspects of Type II and gestational diabetes and the cu rious observation that heroin addicts become diabetic. It can also uni fy clinical thinking about pregnancy-induced hypertension, pre-eclamps ia/eclampsia and acute fatty liver of pregnancy, as well as the coagul opathy of pregnancy. It makes important predictions about perinatal mo rbidity and suggests that early supplementation might prevent much pre gnancy-induced disease.