Pre-eclampsia: pathophysiology, diagnosis, and management

Vasc Health Risk Manag. 2011;7:467-74. doi: 10.2147/VHRM.S20181. Epub 2011 Jul 19.

Abstract

The incidence of pre-eclampsia ranges from 3% to 7% for nulliparas and 1% to 3% for multiparas. Pre-eclampsia is a major cause of maternal mortality and morbidity, preterm birth, perinatal death, and intrauterine growth restriction. Unfortunately, the pathophysiology of this multisystem disorder, characterized by abnormal vascular response to placentation, is still unclear. Despite great polymorphism of the disease, the criteria for pre-eclampsia have not changed over the past decade (systolic blood pressure > 140 mmHg or diastolic blood pressure ≥ 90 mmHg and 24-hour proteinuria ≥ 0.3 g). Clinical features and laboratory abnormalities define and determine the severity of pre-eclampsia. Delivery is the only curative treatment for pre-eclampsia. Multidisciplinary management, involving an obstetrician, anesthetist, and pediatrician, is carried out with consideration of the maternal risks due to continued pregnancy and the fetal risks associated with induced preterm delivery. Screening women at high risk and preventing recurrences are key issues in the management of pre-eclampsia.

Keywords: epidemiology; pathophysiology; pre-eclampsia; therapeutic management.

Publication types

  • Review

MeSH terms

  • Blood Pressure
  • Delivery, Obstetric
  • Female
  • Humans
  • Pre-Eclampsia* / diagnosis
  • Pre-Eclampsia* / mortality
  • Pre-Eclampsia* / physiopathology
  • Pre-Eclampsia* / therapy
  • Predictive Value of Tests
  • Pregnancy
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome