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Review
. 2016 Mar-Apr;27(2):71-8.
doi: 10.5830/CVJA-2016-009.

Pre-eclampsia: its pathogenesis and pathophysiolgy

P Gathiram  1 , J Moodley  2
Affiliations
Review

Pre-eclampsia: its pathogenesis and pathophysiolgy

P Gathiram et al. Cardiovasc J Afr. 2016 Mar-Apr.

Abstract

Pre-eclampsia is a pregnancy-specific disorder that has a worldwide prevalence of 5-8%. It is one of the main causes of maternal and perinatal morbidity and mortality globally and accounts for 50 000-60 00 deaths annually, with a predominance in the low- and middle-income countries. It is a multi-systemic disorder however its aetiology, pathogenesis and pathophysiology are poorly understood. Recently it has been postulated that it is a two-stage disease with an imbalance between angiogenic and anti-antigenic factors. This review covers the latest thoughts on the pathogenesis and pathology of pre-eclampsia. The central hypothesis is that pre-eclampsia results from defective spiral artery remodelling, leading to cellular ischaemia in the placenta, which in turn results in an imbalance between anti-angiogenic and pro-angiogenic factors. This imbalance in favour of anti-angiogenic factors leads to widespread endothelial dysfunction, affecting all the maternal organ systems. In addition, there is foetal growth restriction (FGR). The exact aetiology remains elusive.

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Figures

Fig. 1.
Fig. 1.
Aspects of pathophysiology of pre-eclampsia. VEGF: vascular endothelial growth factor; PlGF: placental growth factor; sFlt-1: soluble film-like tyrosine kinase.
Key messages
Key messages
See this image and copyright information in PMC

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