Vascular function in preeclampsia

Preeclampsia is a multisystem disorder peculiar to human pregnancy. It occu rs in 4-5% of all pregnancies and remains a lending cause of maternal and n eonatal mortality and morbidity. The pathophysiology of this syndrome is no t fully understood. Two stages of vascular dysfunction seem to be involved. In the early stage suboptimal development of the placenta and a hemodynami c maladaptation to pregnancy exist. At this stage maternal constitutional f actors such as genetic and immunological factors and pre-existing vascular diseases may play a role. Due to this defective placentation a factor is re leased from the placenta, supposedly under the influence of ischemia. This factor then results in the late vascular dysfunction characterised mainly b y a generalised endothelial dysfunction, leading to the clinical syndrome o f preeclampsia. This review attempts to unravel the mechanisms that may con tribute to preeclampsia-associated changes in vascular function and to indi cate the research needed to improve our understanding of this disease. (C) 2000 Elsevier Science B.V. All rights reserved.