Angiogenesis and Preeclampsia

Karumanchi, S. Ananth; Stillman, Isaac E.; Lindheimer, Marshall D.

doi:10.1016/b978-0-12-374213-1.00006-9

Cited by 4 publications

(2 citation statements)

References 155 publications

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“…Hence, it is secreted into the circulation where it binds and antagonizes both vascular endothelial growth factor (VEGF) and placenta growth factor (PGF) [15]. Both are potent stimuli for the vascular expansion essential to the development of the uteroplacental unit and act via their effects on endothelial cells [16]. Even more recent clinical evidence has been gathered that supports the notion that both circulating and placental levels of this soluble receptor blocker are higher in women with preeclampsia than in women with uncomplicated pregnancy.…”

Section: Classification Of Hypertensive Disorders Of Pregnancymentioning

confidence: 99%

A Comprehensive Review of Hypertension in Pregnancy

Mustafa

Ahmed

Gupta

et al. 2012

Journal of Pregnancy

229

203

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Hypertension is the most common medical disorder encountered during pregnancy. Hypertensive disorders are one of the major causes of pregnancy-related maternal deaths in the United States. We will present a comprehensive update of the literature pertinent to hypertension in pregnancy. The paper begins by defining and classifying hypertensive disorders in pregnancy. The normal vascular and renal physiological changes which occur during pregnancy are detailed. We will summarize the intriguing aspects of pathophysiology of preeclampsia, emphasizing on recent advances in this field. The existing diagnostic tools and the tests which have been proposed for screening preeclampsia are comprehensively described. We also highlight the short- and long-term implications of preeclampsia. Finally, we review the current management guidelines, goals of treatment and describe the potential risks and benefits associated with various antihypertensive drug classes. Preeclampsia still remains an enigma, and the present management focuses on monitoring and treatment of its manifestations. We are hopeful that this in depth critique will stimulate the blossoming research in the field and assist practitioners to identify women at risk and more effectively treat affected individuals.

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Section: Classification Of Hypertensive Disorders Of Pregnancymentioning

confidence: 99%

A Comprehensive Review of Hypertension in Pregnancy

Mustafa

Ahmed

Gupta

et al. 2012

Journal of Pregnancy

229

203

View full text Add to dashboard Cite

show abstract

“…In fact, abnormal growth of the fetoplacental endothelium has been described as the underlying cause of fetal growth restriction (Kingdom et al 2000; Mayhew et al 2003; Teasdale 1984). Similarly, studies indicate that compromised placenta circulation and dysregulation of angiogenic molecules represent common features of PE and IUGR/FGR (Karumanchi et al 2009; Rana et al 2022). Yet, the underlying mechanisms responsible for dysfunctional placental circulation remain largely elusive.…”

Section: Introductionmentioning

confidence: 99%

Endothelial Dnmt3a controls placenta vascularization and function to support fetal growth

Gehrs

Jakab

Gutjahr

et al. 2022

Preprint

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The fetoplacental capillary network is of vital importance for proper nourishment during early development. Inadequate maternal-fetal circulation has emerged as one of the main pathophysiological features of placental insufficiency. Meta-analysis of human placental endothelial cells (EC) revealed that downregulation of the de novo DNA methyltransferase 3A (DNMT3A) is associated with preeclampsia. However, mechanistic insights into functional consequences of altered DNA methylation patterns during placental vascular development remain elusive. Here, we investigated the role of Dnmt3a in the vasculature during murine placenta development. Spatial and temporal expression analyses revealed an induction of Dnmt3a in the mature labyrinth layer. The global and endothelium-specific loss (ECKO) of Dnmt3a resulted in reduced placental vascularization and fetal growth restriction. EC deleted for Dnmt3a demonstrated extensive loss of DNA methylation, particularly close to angiogenesis related genes. Loss of DNA methylation decreased the angiogenic capacity of EC in vitro and in vivo. Collectively, these data identify DNMT3A as the main DNA methyltransferase in the human and murine placental vasculature and characterize its importance for physiological endothelial function. The Dnmt3a-dependent regulation of genes related to placenta insufficiency validates Dnmt3a ECKO mice as an epigenetically driven mouse model of placenta insufficiency with potential translational relevance.

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Major Changes in Diagnosis and Management of Preeclampsia

Snydal¹

2014

J Midwife Womens Health

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Preeclampsia and eclampsia continue to be major contributors to maternal mortality and morbidity. Lack of appreciation for the multi-organ involvement of preeclampsia, combined with overly rigid criteria for diagnosis, may hinder early diagnosis and appropriate management. Recently, the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy evaluated the evidence and formulated new recommendations for diagnosis and management. This article reviews some of these recommended changes, including the new classification of the hypertensive diseases of pregnancy. Systolic blood pressure has been shown to be as important as diastolic blood pressure in the diagnosis of preeclampsia. Changes in proteinuria are not predictive of disease severity or maternal or fetal complications; therefore, the magnitude of proteinuria or changes in the amount should not dictate diagnosis or management. Instead, symptoms of cerebral involvement, such as headache and visual changes or signs of end-organ involvement including abnormal laboratory tests (elevated serum creatinine or liver function tests, low platelet count), are evidence of preeclampsia with severe features. Immediate induction of labor is recommended for women with gestational hypertension or preeclampsia at 37 weeks' gestation or later. Pregnant and postpartum women need to know important warning signs and symptoms of preeclampsia. Prompt diagnosis of preeclampsia and appropriate management will improve the quality of care for women.

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Angiogenesis and Preeclampsia

Cited by 4 publications

References 155 publications

A Comprehensive Review of Hypertension in Pregnancy

A Comprehensive Review of Hypertension in Pregnancy

Endothelial Dnmt3a controls placenta vascularization and function to support fetal growth

Major Changes in Diagnosis and Management of Preeclampsia

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