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IntroductionPreeclampsia is a disorder of pregnancy, typically characterised by hypertension and proteinuria observed after the 20 th week of gestation. Preeclampsia has dire consequences for both maternal and neonatal health: it is associated with 50,000 -100,000 annual deaths globally, as well as serious fetal and neonatal morbidity and mortality, including increased risk of fetal growth restriction and still birth. Despite the severe health, social and economic costs of preeclampsia, currently the only curative therapy is delivery of the baby and placenta, which itself carries the associated risks of premature birth. The lack of treatments for this condition is attributable to a number of causes, including but not limited to, a partial understanding of the complex pathophysiological mechanisms underlying this complex disease, an inability to sensitively predict women who will go on to develop the disease, and a paucity of robust animal models with which to test new treatments. Areas coveredRecently, progress has been made in identifying potential new therapeutic targets. This review will discuss in detail the evidence supporting further investigation of these targets, which include angiogenic factors, agents which increase vasodilation, anti-inflammatory drugs, substances which reduce oxidative stress and statins. Expert opinion 2This is the authors' final accepted manuscript, post peer review. The publisher's version of record may be found at http://dx.doi.org/10. 1517/14728222.2015.1088004 New therapeutic targets have the potential to make a significant positive impact on maternal and neonatal health. It is exciting that a number of potential therapies are currently being investigated, however it is also vital that basic research continues to identify potential mechanisms and targets, and that any potential therapy is thoroughly tested before progression to clinical trial. KeywordsAngiogenic factors, anti-inflammatory; melatonin, nitric oxide, oxidative stress, preeclampsia, sildenafil, statins, VEGF IntroductionPreeclampsia is a pregnancy specific multisystem disorder characterised by new onset hypertension (systolic blood pressure ≥140 and / or diastolic blood pressure ≥90 mmHg), and involvement of one or more other organ systems after 20 weeks gestation. Proteinuria (> 300 mg / 24hrs) is the most commonly associated additional feature of preeclampsia, but is not mandatory for diagnosis. Other signs or symptoms diagnostic of preeclampsia include fetal growth restriction, neurologic sequelae (convulsions, persistent headache, persistent visual disturbance), renal impairment (oliguria or raised serum creatinine), hematologic sequelae (thrombocytopenia, haemolysis) and liver involvement (raised serum transaminases). 1 The cost of preeclampsia is high, and relates to both the direct costs of monitoring pregnancies and the morbidity and mortality directly associated with preeclampsia, but also to associated conditions such as growth restriction and prematurity. Worldwide, eclampsia (convulsions or...

Abstract-Intrauterine growth restriction (IUGR) causes short-and long-term morbidity. Reduced placental perfusion is an important pathogenic component of IUGR; substances that enhance vasodilation in the uterine circulation, such as sildenafil citrate (sildenafil), may improve placental blood flow and fetal growth. This study aimed to examine the effects of sildenafil in the growth-restricted ovine fetus. Ewes carrying singleton pregnancies underwent insertion of vascular catheters, and then, they were randomized to receive uterine artery embolization (IUGR) or to a control group. Ewes in the IUGR group received a daily infusion of sildenafil (IUGR+SC; n=10) or vehicle (IUGR+V; n=8) for 21 days. The control group received no treatment (n=9

Background The incidence of postpartum anaemia (PPA) in New Zealand, and the extent of intravenous iron (IV‐iron) use in its treatment, are unknown. Aims To report the incidence of PPA in three district health board (DHB) regions and describe current management of moderate to severe PPA, including by ethnicity. Materials and Methods Retrospective observational study of PPA (haemoglobin (Hb) <100 g/L) in three DHBs from July–December 2019. Cases with moderate to severe PPA (Hb <90 g/L) were reviewed and management compared to local and national guidance. Logistic regression examined demographic associations of PPA. Results There were 8849 women who gave birth during the study period: 4076 (46%) had postpartum Hb testing and 1544 (38%) had PPA. Of those tested, and after adjusting for deprivation and region, European women had lower adjusted odds ratios compared to Māori for being identified as having PPA (0.46, 95% CI 0.37–0.57, P < 0.01). Of 681 women with Hb <90 g/L, 278 (41%) received IV‐iron only, 66 (10%) red blood cell transfusion (RBC‐T) only and 155 (23%) both. Of those receiving RBC‐T, 40/221 (18%) were actively bleeding. Māori (92/138, 67%) and Pacific (127/188, 68%) women with Hb <90 g/L had the highest incidence of IV‐iron use. No guidelines provided recommendations for haemodynamically stable women without active bleeding. Conclusion The incidence and management of PPA differs by ethnicity but fewer than half of the women had Hb testing, making precise determination of incidence impossible. The majority of women with Hb <90 g/L received IV‐iron, with or without RBC‐T.