Perspectives on the Pathogenesis and Complications of PE

Abstract

Preeclampsia is a multisystem disorder characterized by hypertension and proteinuria after 20 weeks of gestation. Globally, it is the leading cause of fetal and maternal morbidity and mortality. Nearly 8–10% of women develop hypertension during pregnancy worldwide. Although the actual pathogenesis of PE has not been fully understood, the only cure for the disease is delivery. So, the growing evidence suggests that improper spiral artery remodeling creates placental hypoxia and leads to altered immune response followed by endothelial dysfunction, the release of angiogenic and antiangiogenic factors, and various other vasoactive factors into the maternal circulation. Reliable biochemical markers are needed for the diagnosis of PE at the earliest. MMPs are differentially expressed as a result of the trophoblast invasion’s distinct temporal features. Early in the gestational period, MMPs create the conditions for the ensuing incursion to the placental bed. Endothelial dysfunction is the cause of the clinical sign of the mother such as impairment of the hepatic endothelium causing the HELLP syndrome to develop, impairment of the cerebral endothelium causing refractory neurological problems, or even eclampsia. Also, this chapter reveals the various maternal consequences like HELLP syndrome, Seizure, future cardiovascular events, and end-organ dysfunction; fetal complications include premature delivery, respiratory distress, IUGR, etc.