The immediate and long term disturbances of function in relation to the vascular effects of pre-eclampsia

Singh, Madan Mohan (1976) The immediate and long term disturbances of function in relation to the vascular effects of pre-eclampsia. University of Southampton, Doctoral Thesis.

Abstract

A study has been made of the pre-eclampsia syndrome to assess the immediate effectsof this condition on carbohydrate metabolism and to determine whether the immediate.alterations in blood pressure, renal function and carbohydrate metabolism do predispose to permanent changes in later life.Plasma levels of glucose, human placental lactogen, and immunoreactive insulin wereobserved in the fasting state and for sixty minutes after a glucose challenge. The patients.with severe pre-eclampsia were found to have significantly lower fasting plasma levels of glucose, human placental lactogen and immunoreactive insulin compared with mild preeclamptic and normal pregnant cases. The incidence of abnormal glucose tolerance tests was greatest in the severe pre eclamptic group. In a late follow-up study of patients who had severe pre-eclampsia ten to twenty years previously no significant difference was found in glucose tolerance when compared with a control group of women. It was also found that the majority of women who had severe pre-eclampsia in a first pregnancy had normotensive subsequent pregnancies and in this group the blood pressureat follow-up was significantly lower compared with the group whose subsequent pregnancies were complicated by hypertension or hypertension and proteinuria. Renal investigations which included intravenous pyelography and radio-isotoperenography did not show significant differences in structure and function in the groups. The study suggests That carbohydrate metabolism in severe pre-eclampsia is significantly altered and these alterations are not due to an increase in hormonal factors as postulated by other authors. That despite these changes pre-eclampsia is not a pre-diabetic condition. That true pre-eclampsia is not a pre -hypertensive condition but that women who arefound to be hypertensive following pre-eclampsia most likely have a hypertensive trait. That despite marked renal changes in the acute stages of the disease, renal function is not significantly impaired in later life. It is suggested that the changes described above are a reflection of the vascular reactivity in pre-eclampsia and do not predispose to permanent ill health in later life.

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