The pathogenesis of pre-eclampsia: new aspects

The etiology of pre-eclampsia, a disorder specific to pregnancy, has not ye t been clearly established. Generalized endothelial dysfunction is thought to occur. Inadequate trophoblast invasion at the feto-maternal junction has also been postulated as the cause. However, recent findings are more sugge stive of an inappropriate maternal inflammatory response within the framewo rk of placentation, the innate immune system being primarily involved. This exaggerated maternal intravascular inflammatory reaction to the invading t rophoblast leads to the manifestations of pre-eclampsia in the mother and f ete-placental unit. The extent of the inflammatory reaction, which is also present in normal pregnancy, is probably determined by genetic factors and any pre-existing disorder affecting the mother or fetus. The process is ver y complex and cannot be attributed to any one single cause.