The pathophysiology of pre-eclampsia: Current clinical concepts

D. Cudihy, R. V. Lee
2009 Journal of Obstetrics and Gynaecology  
interactions between senescence of the placenta and a maternal genetic predisposition to cardiovascular and metabolic disease. While often presented as distinct sub-types, in reality the balance between the placental and maternal causations most likely varies among individuals across the spectrum of gestational age at clinical presentation. We discuss the pathophysiology in the light of recent advances of our understanding of the maternalfetal interactions that take place in the first weeks
more » ... the first weeks following implantation, and emphasize the importance of the endometrium during the pre-and peri-conceptional periods for pregnancy success. Sources and selection criteria A PubMed search (pre-eclampsia OR preeclampsia) AND (placenta OR placental)] at the end of 2018 with no date restrictions yielded 10 611 citations. About 10% of our references date from the last century, the earliest to 1953. The rest were published in this millennium, the most recent in 2019, and more than one third in the last five years. We considered only articles published in English. Additional articles and references were obtained by searching the bibliography of published papers. Most of the chosen references are exclusively data based. Trivial, repetitive, or inconsistent research reports were rejected. In this way, we summarized what is known about the pathophysiology and clinical aspects of pre-eclampsia. Definition Defining pre-eclampsia is difficult because it is a syndrome characterized by a group of clinical features that, when they occur together, lead to diagnosis and treatment. There is no gold standard, and all the features
doi:10.1080/01443610903061751 pmid:19757258 fatcat:usduneerujcu7d3c6noywpfmmq