New Approaches for Managing Preeclampsia: Clues From Clinical and Basic Research

Abstract

One of the most common, and most vexing, obstetrical complications is preeclampsia-a major cause of maternal and perinatal morbidity. Hallmarked by new-onset hypertension and a myriad of other symptoms, the underlying cause of the disorder remain obscure, despite intensive research into the etiology. While the initiating events aren’t clear, one common finding in preeclampsia cases is failure of the maternal arteries which supply the placenta, with resulting hypoxia/ischemia. Intensive research over the last two decades has identified several categories of molecular dysfunction resulting from placental hypoxia, which when released into the maternal circulation are responsible for the spectrum of symptoms seen in these patient; in particular angiogenic imbalance and activation of innate and adaptive immune responses. Despite these new insights, little in the way of new treatments have been advanced into clinical practice for the management of these patients. Indeed, little in the way of therapeutic options exist for the obstetrician facing a preeclampsia case. Pharmacological management is typically to seizure prophylaxis and anti-hypertensives in severe cases to try and control the worsening hypertension. Ultimately, induction of labor is indicated; making preeclampsia a leading cause of premature birth. Here, the molecular mechanisms linking placental ischemia to the maternal symptoms of preeclampsia are reviewed, and several areas of recent research suggesting new potential therapeutic approaches for the management of preeclampsia are identified.

Remote Monitoring of Hypertension Diseases in Pregnancy: A Pilot Study

“…When women are diagnosed with preeclampsia, an induction of labor is often necessary for the prevent of further complications [26,27]. The explanation of more inductions in CC could be the higher number of women diagnosed with preeclampsia in this group.…”

Validation of a Metallomics Analysis of Placenta Tissue by Inductively-Coupled Plasma Mass Spectrometry

“…[22,23] Advanced cases of preeclampsia can result in serious medical complications in the mother including stroke and heart disorders, as well as fetal outcomes including IUGR. [24] The development of the placenta has been found to be linked to some of the maternal symptoms of preeclampsia.…”

“…[24] The development of the placenta has been found to be linked to some of the maternal symptoms of preeclampsia. [22] The condition is currently one of the leading causes of mother and infant morbidity and mortality, and is especially prevalent in the developing world, where malnutrition leads to decreased dietary intake of many essential nutrients. [25,26] The occurrence of preeclampsia has also been linked to the development of noncommunicable diseases later in life.…”

Sex Versus Gender: A Touchy Subject for Multiple Sclerosis

“…As her swan song, she has assembled six varied papers related to women's health. [13][14][15][16][17][18] Several of these reports concern women and hypertension. One of them suggests that a sexual dimorphism exists in the functional role played by T cells in the regulation of blood pressure.…”