title: Preeclampsia: a couple's disease with maternal and fetal manifestations.
abstract: Preeclampsia still ranks as one of obstetrics major problems. Clinicians typically encounter preeclampsia as maternal disease with variable degrees of fetal involvement. More and more the unique immunogenetic maternal-paternal relationship is appreciated, and as such also the specific 'genetic conflict' that is characteristic of haemochorial placentation. From that perspective preeclampsia can also been seen as a disease of an individual couple with primarily maternal and fetal manifestations. Factors that are unique to a specific couple would include the length and type of sexual relationship, the maternal (decidual natural killer cells) acceptation of the invading cytotrophoblast (paternal HLA-C), and seminal levels of transforming growth factor-beta and probably other cytokines. The magnitude of the maternal response would be determined by factors including a maternal set of genes determining her characteristic inflammatory responsiveness, age, quality of her endothelium, obesity/insulin resistance and probably a whole series of susceptibility genes amongst which the thrombophilias received a lot of attention in recent years.
authors.affiliation: Women's and Children's Division Lyell McEwin Health Service, Northern Campus University of Adelaide, Haydown Road, Elizabeth Vale, SA 5112, Australia. gustaaf.dekker@adelaide.edu.au
authors.forename: G A
authors.initials: GA
authors.lastname: Dekker
authors.forename: P Y
authors.initials: PY
authors.lastname: Robillard
mesh_terms: D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000209:etiology* / Q000235:genetics; D006680:HLA Antigens / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D007752:Obstetric Labor, Premature / Q000235:genetics / Q000503:physiopathology / Q000628:therapy; D011225:Pre-Eclampsia / Q000209:etiology* / Q000235:genetics / Q000276:immunology; D011247:Pregnancy; D013094:Spermatozoa / Q000502:physiology
chemical_list: D006680:HLA Antigens