Preeclampsia pathophysiology and adverse outcomes during pregnancy and postpartum

Abstract

Background: Preeclampsia is a disease with far-reaching consequences that extend beyond the immediate postpartum period and have a significant impact later in life. Preeclampsia exerts an effect on most organ systems in the body. These sequelae are mediated in part by the incompletely elucidated pathophysiology of preeclampsia and the associated vascular changes.

Content: Current research focuses on unraveling the pathophysiology of preeclampsia with the goal of implementing accurate screening and treatment modalities based on disease development and progression. Preeclampsia causes significant short- and long-term maternal morbidity and mortality, not only in the cardiovascular system but also in other organ systems throughout the body. This impact persists beyond pregnancy and the immediate postpartum period.

Summary: The goal of this review is to discuss the current understanding of the pathophysiology of preeclampsia as it relates to the adverse health consequences in patients impacted by this disease, along with a brief discussion of ways to improve overall outcomes.

Keywords: hypertension; long-term effect; morbidity; preeclampsia; pregnancy.

Figure 1

Two-staged model of preeclampsia pathogenesis. Stage 1 consists of the preclinical stage and is characterized by abnormal placentation, which leads to the release of soluble factors in maternal circulation, leading to systemic endothelial dysfunction and hypertension (Stage 2).

Figure 2

Organ systems impacted by preeclampsia. The figure shows various organ systems affected by preeclampsia leading to short-term and long-term maternal/fetal morbidity and mortality.