[Hypotension during pregnancy and premature delivery (author's transl)].

In 70 healthy pregnant women with blood pressure values of 110/65 mm Hg or below placenta perfusion measurements were performed. In 80% the utero-placental blood flow was reduced. As a consequence 40 of the hypotensive gravidae were treated with mineralocorticoids. In this way a marked improvement in utero-placental perfusion was achieved. 6 of the 30 gravidae without treatment (20%) delivered prematurely (before the 38th week of gestation). In the group treated with mineralocorticoids only 2 of the 40 hypotensive women (5%) delivered before term. The average birth weight of the children of the treated mothers was 500 g higher than in the untreated group. There was no case of prenatal dystrophy in the treated group. Hypotension during pregnancy therefore should be treated in order to increase the blood supply of the fetus. Mineralocorticoids are to be preferred to sympathomimetic agents, since they act on the venous side of the maternal circulation.