Placental Dysfunction as a Key Element in the Pathogenesis of Preeclampsia.


eMediNexus    11 January 2018

A recent article published in the Developmental Period Medicine reported that placental pathology is associated with major pregnancy disorders, and the concept of the Great Placental Syndromes includes disorders of placentation: preeclampsia with and without fetal growth restriction, preterm labor, preterm premature rupture of membranes, late spontaneous abortion, and placental abruption. This article discussed that while preeclampsia can be of either early or late onset variety, placental dysfunction is a central feature in the pathogenesis of both. In the early onset preeclampsia, syncytiotrophoblastic stress seems to be related to an inherent defect of the trophoblast; wherein vascular protection of early placental development is replaced by vascular dysfunction. Whereas, in late onset preeclampsia, maternal factors, such as genotypic predisposition to endothelial disease, and an impairment of antioxidant defence with a limited capacity of the maternal clearing system to cope with the increasing charge of apoptotic cell debris, are at the center of pathogenesis. It was stated that syncytiotrophoblastic stress in late pregnancy has been related to molecular senescence, and late onset preeclampsia may be an exaggeration of normal placental ageing.

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