Preeclampsia – from enigmatic syndrome to targeted therapy
Abstract
Preeclampsia is a devastating systemic disease complicating 3-8% of all pregnancies and culpable of maternal and fetal morbidity and mortality worldwide. Although known since ancient times only now medical science is beginning to comprehend the molecular mechanisms of the disease and starts paving the way towards targeted therapies. The breakthrough discovery of the essential role of anti-angiogenic factors in the pathogenesis of generalized endothelial dysfunction has revolutionized our understanding of preeclampsia. Currently, therapeutic approaches restoring the angiogenic balance are being developed in a joint endeavor by nephrologists, obstetricians, and neonatologists. There is evidence that preeclampsia may develop on the grounds of chronic hypertension, chronic kidney disease, autoimmune disease, diabetes mellitus, and obesity. In addition, preeclampsia is recognized as a risk factor for cardio-vascular disease, chronic hypertension, and kidney disease later in life. Thus, internists should be aware of preeclampsia. Not only will they counsel patients at risk for preeclampsia and the desire to have children, but they will also tailor long-term follow-up for patients with a history of preeclampsia which puts them at specific future risk. Finally, nephrologists will be involved in extracorporeal therapies treating preeclamptic patients.
This article aims to give an overview of the current understanding of preeclampsia summarizing knowledge on the molecular pathogenesis of the disease, new tools for early diagnosis, classic risk factors for preeclampsia, and health risk attributable to a previous history of preeclampsia. In addition, current treatment options and evolving targeted treatment strategies for preeclampsia are discussed.
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DOI: http://dx.doi.org/10.18103/imr.v3i1.289
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