Vascular Dysfunction in Mother and Offspring During Preeclampsia: Contributions from Latin-American Countries

Abstract

Pregnancy is a physiologically stressful condition that generates a series of functional adaptations by the cardiovascular system. The impact of pregnancy on this system persists from conception beyond birth. Recent evidence suggests that vascular changes associated with pregnancy complications, such as preeclampsia, affect the function of the maternal and offspring vascular systems, after delivery and into adult life. Since the vascular system contributes to systemic homeostasis, defective development or function of blood vessels predisposes both mother and infant to future risk for chronic disease. These alterations in later life range from fertility problems to alterations in the central nervous system or immune system, among others. It is important to note that rates of morbi-mortality due to pregnancy complications including preeclampsia, as well as cardiovascular diseases, have a higher incidence in Latin-American countries than in more developed countries. Nonetheless, there is a lack both in the amount and impact of research conducted in Latin America. An impact, although smaller, can be seen when research in vascular disorders related to problems during pregnancy is analyzed. Therefore, in this review, information about preeclampsia and endothelial dysfunction generated from research groups based in Latin-American countries will be highlighted. We relate the need, as present in many other countries in the world, for increased effective regional and international collaboration to generate new data specific to our region on this topic.

Novel Insights Into the Role of Glycans in the Pathophysiology of Glomerular Endotheliosis in Preeclampsia

“…Preeclampsia exhibits diverse clinical manifestations such as mild or severe, early onset (<34 weeks) or late onset (>34 weeks), or the presence or absence of intrauterine growth retardation ( Gilstrap and Ramin, 2002 ; Giachini et al, 2017 ). Accumulating evidence has shown that pathological features of preeclampsia involve a shallow trophoblast invasion and poor spiral artery remodeling, resulting in placental hypoperfusion.…”

Características clínicas y fisiológicas del síndrome de Hellp

“…Una de las teorías más aceptadas para la presentación de complicaciones hipertensivas en el embarazo, es la implantación insuficiente de las células del citotrofoblasto, que se infiltran en la porción decidual de las arterias espirales, pero no penetran en su segmento miometrial (14,15). Las arterias espirales, por lo tanto, no se transforman en canales vasculares de gran capacitancia, sino que se mantienen estrechas, lo que resulta en una disminución en el flujo placentario (16)(17)(18). y da como resultado una alta velocidad de perfusión en el espacio intervelloso, lo que genera estrés de cizallamiento en el trofoblasto (19,20).…”

Antioxidants and Oxidative Stress: Focus in Obese Pregnancies

“…PE is a severe disease characterized by the presence of hypertension and proteinuria during the second and third trimester of gestation ( Steegers et al, 2010 ). PE affects approximately 2–8% of all pregnancies ( Ghosh et al, 2014 ) and is associated with substantially higher maternal and fetal morbidity and mortality worldwide, especially in Latin American countries where PE is one of the leading causes of maternal and fetal mortality ( Giachini et al, 2017 ).…”