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Preeclampsia: Pathophysiology, Challenges, and Perspectives

Sarosh Rana1, Elizabeth Lemoine2,3, Joey P Granger4

  • 1From the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Chicago, IL (S.R.).

Circulation Research
|March 29, 2019
PubMed
Summary
This summary is machine-generated.

Hypertensive disorders in pregnancy, like preeclampsia, pose risks to mothers and infants. Research highlights abnormal placentation and soluble fms-like tyrosine kinase 1 (sFLT1) in preeclampsia development and long-term health risks.

Keywords:
biomarkersblood pressurecardiovascular diseasepreeclampsiapregnancy

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Cardiovascular and Metabolic Health

Background:

  • Hypertensive disorders of pregnancy, including chronic hypertension, gestational hypertension, and preeclampsia, present complex challenges due to dual maternal-fetal impact.
  • Preeclampsia is a severe complication, often developing in the third trimester, characterized by new-onset hypertension and proteinuria, with potential for rapid progression to life-threatening outcomes for both mother and fetus.

Purpose of the Study:

  • To review evidence on abnormal placentation and placental factors, specifically soluble fms-like tyrosine kinase 1 (sFLT1), in preeclampsia pathogenesis.
  • To discuss the utility of angiogenic biomarker assays for risk stratification and developing targeted therapies.
  • To examine the long-term cardiovascular and metabolic risks associated with gestational hypertensive disorders, particularly preterm preeclampsia.

Main Methods:

  • Review of current clinical and pathological studies on preeclampsia.
  • Analysis of research on placental factors and angiogenic biomarkers.
  • Examination of epidemiological data on long-term health outcomes in mothers and children.

Main Results:

  • The placenta is implicated as central to preeclampsia pathogenesis.
  • Abnormal placentation and factors like sFLT1 play significant roles in the maternal syndrome.
  • Gestational hypertensive disorders, especially preterm preeclampsia, are linked to substantial long-term maternal and child cardiovascular and metabolic risks.

Conclusions:

  • Understanding placental factors is crucial for managing preeclampsia.
  • Angiogenic biomarker assays offer potential for risk stratification and targeted therapeutic development.
  • Interventional studies focusing on the asymptomatic phase are needed to mitigate long-term cardiovascular disease risk.