Abstract
Pre-eclampsia is a multisystem disorder of pregnancy, characterised by hypertension and proteinuria, occurring after 20 weeks of gestation. As well as being associated with pregnancy complications such as preterm delivery and foetal growth restriction, pre-eclampsia is now increasingly known to be associated with cardiovascular diseases in later life. Despite decades of research into the condition, it remains difficult to predict, difficult to diagnose and difficult to treat.
In this chapter pathophysiological mechanisms and origins of disease will be discussed, with a focus on placental and cardiovascular factors. Potential markers to improve early prediction of disease and therapeutic strategies will be discussed, as well as the relationship between pre-eclampsia and future maternal health problems.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Shennan AH, Green M, Chappell LC. Maternal deaths in the UK: pre-eclampsia deaths are avoidable. Lancet. 2017;389(10069):582–4.
Wikstrom AK, Gunnarsdottir J, Cnattingius S. The paternal role in pre-eclampsia and giving birth to a small for gestational age infant; a population-based cohort study. BMJ Open. 2012;2(4).
Bartsch E, Medcalf KE, Park AL, Ray JG. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ. 2016;353:i1753.
Purswani JM, Gala P, Dwarkanath P, Larkin HM, Kurpad A, Mehta S. The role of vitamin D in pre-eclampsia: a systematic review. BMC Pregnancy Childbirth. 2017;17(1):231.
Dodd JM, Louise J, Deussen AR, et al. Effect of metformin in addition to dietary and lifestyle advice for pregnant women who are overweight or obese: the GRoW randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2019;7(1):15–24.
Kleinrouweler CE, Wiegerinck MM, Ris-Stalpers C, et al. Accuracy of circulating placental growth factor, vascular endothelial growth factor, soluble fms-like tyrosine kinase 1 and soluble endoglin in the prediction of pre-eclampsia: a systematic review and meta-analysis. BJOG. 2012;119(7):778–87.
Agrawal S, Cerdeira AS, Redman C, Vatish M. Meta-analysis and systematic review to assess the role of soluble FMS-like tyrosine Kinase-1 and placenta growth factor ratio in prediction of preeclampsia: the SaPPhirE study. Hypertension. 2018;71(2):306–16.
North RA, McCowan LM, Dekker GA, et al. Clinical risk prediction for pre-eclampsia in nulliparous women: development of model in international prospective cohort. BMJ. 2011;342:d1875.
O’Gorman N, Nicolaides KH, Poon LC. The use of ultrasound and other markers for early detection of preeclampsia. Womens Health (Lond). 2016;12(2):199–207.
Pathak S, Lees CC, Hackett G, Jessop F, Sebire NJ. Frequency and clinical significance of placental histological lesions in an unselected population at or near term. Virchows Arch. 2011;459(6):565–72.
Carty DM, Delles C, Dominiczak AF. Preeclampsia and future maternal health. J Hypertens. 2010;28(7):1349–55.
Davis EF, Newton L, Lewandowski AJ, et al. Pre-eclampsia and offspring cardiovascular health: mechanistic insights from experimental studies. Clin Sci (Lond). 2012;123(2):53–72.
Jayet PY, Rimoldi SF, Stuber T, et al. Pulmonary and systemic vascular dysfunction in young offspring of mothers with preeclampsia. Circulation. 2010;122(5):488–94.
Lu F, Bytautiene E, Tamayo E, et al. Gender-specific effect of overexpression of sFlt-1 in pregnant mice on fetal programming of blood pressure in the offspring later in life. Am J Obstet Gynecol. 2007;197(4):418–5.
Kalafat E, Thilaganathan B. Cardiovascular origins of preeclampsia. Curr Opin Obstet Gynecol. 2017;29(6):383–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Carty, D. (2019). Pre-eclampsia. In: Touyz, R., Delles, C. (eds) Textbook of Vascular Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-16481-2_34
Download citation
DOI: https://doi.org/10.1007/978-3-030-16481-2_34
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-16480-5
Online ISBN: 978-3-030-16481-2
eBook Packages: MedicineMedicine (R0)