Abstract
Preeclampsia is a pregnancy specific disease, defined by a new onset of hypertension and proteinuria. It affects up to 4% of all pregnancies, and untreated it can develop to eclampsia. It may also be the cause of intrauterine growth restriction. The objective of this assignment is to examine the mechanisms behind the disease and the future risks regarding subsequent pregnancies and cardiovascular disease. Management of affected patients will also be reviewed. The pathogenesis behind the disease is still not fully known. A central aspect in the development of preeclampsia is a failure of trophoblast invasion of the spiral arteries during placentation. The result is low perfusion of the uteroplacental unit, and increased release of placental factors affecting the maternal circulation. High levels of sFlt-1 binding and inactivating VEGF and PlGF, endothelin-1 and angiotensin II autoantibodies all affect the maternal circulation and are believed to contribute to the endothelial dysfunction. Hypertension, overweight, age and other maternal factors also increase the risk of preeclampsia. The risks of recurrence in subsequent pregnancies and cardiovascular disease are increased compared to women without a history of preeclampsia. Women who have had preeclampsia in a prior pregnancy should receive counselling by experienced obstetricians before their next pregnancy and a close follow-up. The goal in the management is to reduce maternal risk factors and optimize maternal health before conception and detect complications as early as possible during pregnancy. More research is necessary to achieve full knowledge of the disease.