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Review Papers | Community Medicine | India | Volume 13 Issue 3, March 2024

Unlocking the Secrets of Electrolyte Physiology in Pre-Eclampsia: A Vital Insight into Maternal and Fetal Health and its Management

Dr. Abhishek Dhawan | Dr. Adchitre S. A. | Dr. Salve S. B. | Dr. Tayade D. N.

Abstract: Pre - eclampsia is a multisystemic illness of pregnancy in people who are predisposed genetically. It more frequently happens in first pregnancies, and while it raises blood pressure, it mostly affects the mother's renal, cerebral, hepatic, and coagulation capabilities. The fetus shows detrimental effects because of placental insufficiency brought on by improper "placentation" or the inadequate penetration of the maternal vasculature by trophoblasts, and sometimes maybe because of abnormal autocoid production. The placenta is the causative behind pre - eclampsia, and the only known treatment is delivery of the placenta. Its symptoms are thought to be secondary to organ hypoperfusion, which results from vasoconstriction, intravascular coagulation, and a decreased amount of maternal blood. According to most recent theories, pre - eclampsia is caused by excessive damage to maternal endothelium, possibly due to a cytotoxic substance secreted by the placenta. Although, this theory is widely accepted, there is little scientific support for it. It has proven to be challenging to define the aberrant balance of vasoactive factors in pre - eclampsia. Despite lower plasma concentrations of angiotensin II (A - II), Renin, and Aldosterone, injected Angiotensin - II had increased pressor activity. The balance of thromboxane/prostacyclin favors vasoconstriction and platelet aggregation, and prostacyclin production appears to be diminished. Neither decreased nitric oxide production nor increased endothelin production are suggested by strong evidence. In spite of the contraction in plasma volume, Atrial Natriuretic Peptide (ANP) concentrations in plasma are strangely increased. For e. g., why one patient experiences hepatic ischemia, and another has a comparable level of hypertension but involves a different organ system, such as renal insufficiency but adequate liver function, is a fascinating discovery that has not yet been fully explained. Volume homeostasis is disturbed with re - distribution of intravascular volume of fluids to the interstitial fluid area because of raised capillary permeability and also in some instances decreased plasma oncotic pressure. This re - distribution is not always clinically apparent as peripheral edema. Whether this change in volume of fluids is compensated for by veno - constriction and maintenance of ample cardiac output is undetermined. Improved understanding of the pathology of pre - eclampsia is absolutely necessary to allow better clinical assessment of this consequential disorder.

Keywords: multisystemic illness, organ hypoperfusion, cytotoxic, Atrial Natriuretic Peptide, Capillary Permeability, Consequential Disorder

Edition: Volume 13 Issue 3, March 2024,

Pages: 96 - 103