Current understanding of pre-eclampsia.
BACKGROUND
Pre-eclampsia is associated with significant morbidity and mortality for mother and baby, with post partum resolution. The disorder is triggered by a placental pathology followed by a wide spectrum of maternal systemic response. However, there remains controversy in practically every aspect of the condition.


METHODS
A Medline search and hand search of recent publications pertaining to the scientific basis and clinical management of pre-eclampsia.


RESULTS
With current interest in the scientific and molecular basis of the disease process, there has been an improved, albeit incomplete, understanding of the precise aetiology and pathogenesis of pre-eclampsia. Much of this has translated to improved clinical management strategies. The more rational use of various pharmacological agents, timing the delivery to optimise both the maternal and fetal condition, the decreasing rate of eclampsia, as well as trials on various screening and prophylactic strategies are testimony to this improvement. Despite this, many unanswered questions still remain and provide a challenge for both the clinician as well as the researcher.


CONCLUSIONS
We reviewed the recent literature in order to provide a contemporary understanding of the basic pathogenesis of the condition as well as to highlight some basic strategies for clinical management. There is a clear need for more research to better understand the basic science behind the genesis of this condition, as well as to improve the level of care we offer to these women through the co-ordination of a multi-disciplinary team of clinicians.
Kwek
K
K
Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899.
Yeo
G S H
GS
D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D015415:Biomarkers; D036861:Delivery, Obstetric / Q000379:methods; D018450:Disease Progression; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D008967:Molecular Biology; D009154:Mutation / Q000235:genetics; D018384:Oxidative Stress; D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics; D010298:Parity; D010348:Patient Care Team; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods; D011322:Primary Prevention / Q000379:methods; D018455:Protein S Deficiency / Q000150:complications; D012307:Risk Factors; D012747:Sexual Partners
D000925:Anticoagulants; D015415:Biomarkers; D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D001241:Aspirin