[Preeclampsia--two manifestations of the same disease]

Preeclampsia, due to its complicated and unexplained pathophysiology, remains one of the most difficult subjects in modern maternal-fetal medicine. Despite of the fact that diagnostic criteria of preeclampsia are clear and homogenous, the clinical manifestation of the disease, the prognosis and the frequency of maternal and fetal complications differ considerably among the cases. The aim of the review was to emphasize the heterogenous character of preeclampsia which may be manifested in two different clinical forms--a maternal and placental one. The maternal preeclampsia occurs mostly in multiparous patients with known risk factors of preeclampsia such as: 1) insulin resistance, 2) diabetes mellitus, 3) dyslipidemia, 4) obesisty, and 5) chronic hypertension. The placental form of the disease is more common among nulliparous women without prior risk factors of preeclampsia. The main clinical differences between the two forms are: 1) an earlier onset of placental preeclampsia in most cases, and 2) a more frequent presence of placental insufficiency in placental preeclampsia. The following article focuses on both forms of preeclampsia in the aspect of different clinical manifestations, different prognosis, as well as different management of the disease.