Understanding Preeclampsia: Cardiovascular Pathophysiology, Histopathological Insights and Molecular Biomarkers

Area of Science:

• Obstetrics and Gynecology
• Cardiovascular Medicine
• Pathology

Background:

• Preeclampsia (PE) is diagnosed after 20 weeks gestation, marked by hypertension and proteinuria or organ damage.
• It stems from placental issues, leading to ischemia and release of antiangiogenic factors (sFlt-1, sEng).
• These factors cause systemic endothelial dysfunction, hypertension, and multiorgan stress, with histopathological evidence of vascular damage.

Purpose of the Study:

• To review the vascular and histological mechanisms of preeclampsia.
• To highlight novel biomarkers and advanced diagnostic tools for PE.
• To underscore PE's role as an early marker for future cardiovascular disease.

Main Methods:

• Synthesis of emerging evidence on PE mechanisms.
• Review of histopathological findings in PE.
• Exploration of novel biomarkers (microRNAs, neprilysin) and diagnostic tools (machine learning).

Main Results:

• Impaired placental development and defective spiral artery remodeling are central to PE.
• Circulating antiangiogenic factors contribute to endothelial dysfunction and multiorgan stress.
• PE is linked to significant long-term cardiovascular disease risk.

Conclusions:

• Preeclampsia is a critical indicator of underlying vascular dysfunction and future cardiovascular risk.
• Pregnancy offers a unique window for early detection and intervention in women's cardiovascular health.
• Personalized prevention, surveillance, and long-term follow-up are essential for women with a history of PE.