Updates on Preeclampsia: Pathogenesis, Biomarkers, Diagnosis, and Management.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Cardiovascular Research

Background:

• Preeclampsia affects 2-4% of pregnancies, causing significant maternal and fetal morbidity/mortality.
• Early-onset preeclampsia (<34 weeks) involves abnormal placentation; late-onset (>34 weeks) involves perfusion/metabolic mismatch.
• Angiogenic imbalance (elevated antiangiogenic factors like sFlt-1, soluble endoglin; decreased proangiogenic PlGF) is key.

Purpose of the Study:

• To comprehensively review the pathogenesis, diagnosis, biomarkers, and management of preeclampsia.
• To highlight the role of angiogenic imbalance in preeclampsia development.
• To discuss current and emerging therapeutic strategies and long-term health implications.

Main Methods:

• Review of existing literature on preeclampsia.
• Analysis of diagnostic criteria and biomarkers, including the sFlt-1/PlGF ratio.
• Examination of prevention strategies, current treatments, and novel therapeutic investigations.

Main Results:

• Preeclampsia diagnosis involves hypertension, proteinuria, end-organ damage, or uteroplacental dysfunction.
• The sFlt-1/PlGF ratio is an FDA-approved tool for preeclampsia risk assessment.
• Low-dose aspirin is a primary prevention strategy for high-risk women.

Conclusions:

• Delivery is the definitive treatment, but novel therapies (apheresis, siRNA, metformin, etc.) are under investigation.
• Women with preeclampsia history have increased long-term cardiovascular, renal, and metabolic risks.
• Comprehensive post-pregnancy follow-up is essential for managing long-term health risks.