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(Hypertension. 2008;51:989.)
© 2008 American Heart Association, Inc.

Go Red Editorial Commentaries

Preeclampsia More Than 1 Disease

Or Is It?

James M. Roberts; Janet M. Catov

From the Magee-Womens Research Institute, Department of Obstetrics, Gynecology, & Reproductive Sciences and Epidemiology, University of Pittsburgh School of Medicine, Pa.

Correspondence to James M. Roberts, MD, Senior Scientist, Magee-Womens Research Institute, Professor of Obstetrics, Gynecology & Reproductive Sciences and Epidemiology, Graduate School of Public Health, University of Pittsburgh School of Medicine, 204 Craft Avenue, Pittsburgh, PA 15213. E-mail rsijmr@mwri.magee.edu

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

In this issue of Hypertension, Rasmussen and Irgens provide strong support for the relationship of preeclampsia and intrauterine growth restriction (IUGR). They also provide data that support but also some that argue against the concept that the pregnancy complication, preeclampsia, may be more than one disease.¹ In previous studies these authors demonstrated that women who have had a growth-restricted infant without preeclampsia are more likely to have preeclampsia in a subsequent pregnancy.²

Those data and similar findings in the current study support pathological findings indicating the similarity of IUGR and preeclampsia.³ In preeclampsia, IUGR and interestingly also in about one third of cases of preterm birth,⁴ the maternal myometrial and decidual vessels perfusing the placental site do not undergo the normal remodeling of pregnancy. In normal pregnancy trophoblastic invasion is associated with a greatly increased diameter and removal of vascular smooth muscle from the wall of these vessels. This results in large diameter, flaccid, unresponsive tubes that greatly increase placental perfusion. These changes are not present in pregnancies complicated by IUGR, preeclampsia, and some with preterm births. Implicit in the current study is the concept that preterm birth as well as IUGR is related to subsequent preeclampsia. Although preterm birth is not assessed directly, the effect of low birth weight (IUGR and preterm birth) was greater than the effect of IUGR alone. In a far smaller study our group was able to more directly support the relationship of preterm birth and preeclampsia, as women with early onset preeclampsia were . . . [Full Text of this Article]

Related Article:

History of Fetal Growth Restriction Is More Strongly Associated With Severe Rather Than Milder Pregnancy-Induced Hypertension

Svein Rasmussen and Lorentz M. Irgens
Hypertension 2008 51: 1231-1238. [Abstract] [Full Text] [PDF]

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