A Brief Overview of Preeclampsia

Abstract

Preeclampsia (PE) is a leading cause of maternal mortality and morbidity worldwide. It occurs in women with first or multiple pregnancies and is characterized by new onset hypertension and proteinuria. Improper placentation is mainly responsible for the disease. If PE remains untreated, it moves towards more serious condition known as eclampsia. Hypertension, diabetes mellitus, proteinuria, obesity, family history, nulliparity, multiple pregnancies and thrombotic vascular disease contribute as the risk factors for PE. PE triggered metabolic stress causes vascular injury, thus contributing to the development of cardiovascular disease (CVD) and/or chronic kidney disease (CKD) in future. This risk appears to be increased especially in women with a history of recurrent PE and eclampsia. Clinically increased serum levels of sFlt-1 and decreased placental growth factor (PIGF) and vascular endothelial growth factor (VEGF) represent the severe condition of PE. The clinical findings of sever PE are assorted by the presence of systemic endothelial dysfunction, microangiopathy, the liver (hemolysis, elevated liver function tests and low platelet count, namely HELLP syndrome) and the kidney (proteinuria). The early detection of PE is one of the most important goals in obstetrics.

SASH1, a new potential link between smoking and atherosclerosis

“…Preeclampsia is a complication during pregnancy characterized by hypertension and proteinuria, leading to vascular and organ damages and sometimes, death 201 . While its exact cause is unknown, an abnormally poor vascularization of the placenta could be the at the origin of this condition 202 .…”

Long-term maternal atherosclerotic morbidity in women with pre-eclampsia

“…These disorders are considered among the main obstetrical causes for maternal death during pregnancy 1 2. There are several proposed mechanisms regarding the pathogenesis of pre-eclampsia, most of them involve the placenta as a central organ for the development of this disorder with placental-derived soluble factor that influence the systemic vascular system 3 4. In recent years, there is a growing interest regarding the link between pre-eclampsia and future risk for atherosclerotic morbidity including both cardiovascular5–11 and renal12–14 morbidity.…”

Preeclampsia and Maternal Cardiovascular Disease: Consequence or Predisposition?

“…PE occurs in 3-8% of pregnancies and is a leading cause of maternal and perinatal morbidity and mortality worldwide [13,14]. Primarily diagnosed by new-onset hypertension, commonly combined with proteinuria and other end-organ injury during pregnancy, PE usually develops in the second half of gestation and may be associated with headache, edema, abdominal pain, disseminated intravascular coagulation, hepatic or renal problems and visual disturbances.…”