title: Pre-eclampsia: its pathogenesis and pathophysiolgy.
abstract: Pre-eclampsia is a pregnancy-specific disorder that has a worldwide prevalence of 5-8%. It is one of the main causes of maternal and perinatal morbidity and mortality globally and accounts for 50 000-60 00 deaths annually, with a predominance in the low- and middle-income countries. It is a multi-systemic disorder however its aetiology, pathogenesis and pathophysiology are poorly understood. Recently it has been postulated that it is a two-stage disease with an imbalance between angiogenic and anti-antigenic factors. This review covers the latest thoughts on the pathogenesis and pathology of pre-eclampsia. The central hypothesis is that pre-eclampsia results from defective spiral artery remodelling, leading to cellular ischaemia in the placenta, which in turn results in an imbalance between anti-angiogenic and pro-angiogenic factors. This imbalance in favour of anti-angiogenic factors leads to widespread endothelial dysfunction, affecting all the maternal organ systems. In addition, there is foetal growth restriction (FGR). The exact aetiology remains elusive.
authors.affiliation: Department of Physiology, Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: P
authors.initials: P
authors.lastname: Gathiram
authors.affiliation: Department of Obstetrics and Gynaecology and Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. Email: jmog@ukzn.ac.za.
authors.forename: J
authors.initials: J
authors.lastname: Moodley
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation / Q000378:metabolism*; D006801:Humans; D007511:Ischemia / Q000378:metabolism / Q000503:physiopathology*; D008428:Maternal Mortality; D010920:Placenta / Q000378:metabolism / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000503:physiopathology*; D011247:Pregnancy; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000378:metabolism*
chemical_list: D040281:Vascular Endothelial Growth Factor Receptor-1