STUDY ON THE PATHOPHYSIOLOGY OF PREECLAMPSIA : THE MECHANISM OF VASOSPASMS

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Preeclampsia has pathophysiological disorders specific to pregnancy characterized by vasoconstriction and hypercoagulability. We investigated MR angiography in many cases of preeclampsia and revealed vasospasms of cerebral arteries. We proposed that preeclampsia was the angiospastic syndrome of pregnancy from the view point of vasospasms.An analysis of the results of coagulation/fibrinolysis investigation lead to the hypothesis that 1) even in patients with severe preeclampsia, vaginal deliveries can be successful in cases with a lower hypercoagulable state, 2) an excessive hypercoagulable state in patients with severe preeclampsia is associated with the termination of pregnancy, especially resulting from the aggravation of maternal factors, and 3) among these markers, a depletion in platelet counts (DELTA pit) and an increase in the D-dimer and AT-Ill during pregnancy are thought to be useful bedside predictive markers for the termination of pregnancy complicated by severe preeclampsia.Chronic local cold stimulation of the soles of the paws induces preeclampsia-like phenomena in pregnant and nonpregnant rats, and we revealed the effectiveness of long-term epidural anesthesia by bupivacaine in patients with severe preeclampsia. These facts suggest that the cause of preeclampsia is involved in chronic stimulation of the sympathetic nerve.