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(Hypertension. 2008;52:805.)
© 2008 American Heart Association, Inc.

Editorial Commentaries

Maternal and Uteroplacental Hemodynamics for the Classification and Prediction of Preeclampsia

Baha M. Sibai

From the Department of Obstetrics and Gynecology, University of Cincinnati, Ohio.

Correspondence to Professor Baha Sibai, MD, Department of Obstetrics and Gynecology, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0526 E-mail baha.sibai@uc.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Preeclampsia is a major cause of maternal and perinatal mortality and morbidities worldwide, and its etiology remains unknown. The reported incidence of preeclampsia in healthy nulliparous women is approximately 6%, with 93% of cases developing at 34 weeks gestation.¹

Knowledge about the pathogenesis of preeclampsia has changed significantly over the past decade by virtue of increased recognition of the heterogenous nature of this syndrome. Patients with preeclampsia can present with a wide spectrum of clinical manifestations in the mother and fetus. The degree of maternal hypertension, the amount of proteinuria, and the presence or absence of laboratory abnormalities are highly variable (ranging from mild to severe), with a variable time of onset.² The manifestations of preeclampsia can develop at <34 weeks (early onset), at 34 weeks (late onset), during labor, or postpartum. Recently, it has been suggested that early and late onset preeclampsia may have different pathophysiology. Early onset preeclampsia is usually associated with fetal growth restriction (FGR) and evidence of ischemic lesions on placental examination, whereas late onset preeclampsia is not usually associated with FGR or ischemic placental lesions.³

Pregnancy is characterized by certain structural and functional changes in the cardiovascular systems that are necessary to accommodate the growing demands of the fetus and placenta. Adequate cardiovascular adaptation during early pregnancy leads to a state of high blood flow and low vascular resistance, which is a prerequisite to successful pregnancy outcome. In contrast, inadequate or excessive cardiovascular adaptation before 20 weeks gestation is associated with pregnancies complicated by gestational . . . [Full Text of this Article]

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Early and Late Preeclampsia: Two Different Maternal Hemodynamic States in the Latent Phase of the Disease

Herbert Valensise, Barbara Vasapollo, Giulia Gagliardi, and Gian Paolo Novelli
Hypertension 2008 52: 873-880. [Abstract] [Full Text] [PDF]