PL 1 Preeclampsia is not a placental disorder

Publication date: July 2017 Source:Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, Volume 9 Author(s): Baskaran Thilaganathan Human placentation is uniquely associated with physiological remodelling of the spiral arteries by the invading trophoblast to produce a low resistance uterine circulation. Defective placentation is associated with persistence of a high-resistance uterine circulation, impaired placental perfusion and a placental ‘stress’ response leading to the development of preeclampsia (PE). An imbalance of antigenic and antiangiogenic factors have the highest accuracy in predicting pregnancy complications associated with PE in late pregnancy. Despite these advances in delineating pathophysiology, the aetiology of preeclampsia is still largely unresolved – being labelled a “disease of theories”. According to the two-stage theory of preeclampsia, the maternal syndrome, hypertension and proteinuria, constitute the end-stage of a pathogenic cascade beginning earlier in pregnancy. The initial insult, a failure in trophoblast invasion, is localized to the placenta. It has been proposed that placental dysfunction disorders such as early onset PE comprise a disease entity, which is more or less distinct from late onset PE. The latter has been attributed as “maternal” preeclampsia, while the first has been dubbed as “fetal” preeclampsia. This dichotomy is rather simplistic. A systematic review of the literature does no...
Source: Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health - Category: OBGYN Source Type: research