Early and late onset preeclampsia: Two sides of the same coin

医学 子痫前期 宫内生长受限 胎盘 怀孕 子痫 胎盘形成 绒毛间隙 弹性蛋白 合胞滋养细胞 心脏病学 产科 内科学 病理 妊娠期 胎儿 生物 遗传学
作者
C.W.G. Redman
出处
期刊:Pregnancy Hypertension [Elsevier BV]
卷期号:7: 58-58 被引量:29
标识
DOI:10.1016/j.preghy.2016.10.011
摘要

Pre-eclampsia is caused by the placenta. Although its pathogenesis is not clear, a critical risk factor is inadequate antenatal care, because it can prevent most of the secondary complications of the disorder. Pre-eclampsia is clinically defined by the secondary features of a primary placental disorder. There are probably several subtypes of preeclampsia of which early (EO-PE) and late onset disease (LO-PE) are the best known. These are classified by the time of delivery- EO-PE, delivered before 34 weeks and LO-PE, after 37 weeks; while intermediate onset disease (34–37ẇeeks) is a mixture of both types. One of the major differences is that EO-PE is usually complicated by intrauterine growth restriction (IUGR) while LO-PE is not. Another difference is that there is clear placental pathology with EO-PE while LO-PE placentas are usually normal to routine clinicopathological examination. The pathology of EO-PE comprises lesions of uteroplacental malperfusion. These are associated with maladaptation of the uteroplacental spiral arteries in early pregnancy (8–18 weeks, poor placentation) such that they are too small and too contractile to sustain the non-pulsatile, high volume, low pressure flow needed by the third trimester placenta. The result is oxidative stress and even infarction that damage placental tissue. The spiral arteries may also be obstructed by acute atherosis and atherosclerosis-like lesion that causes arterial thrombosis which underlies the infarctions. The surface syncytiotrophoblast layer, in direct contact with maternal blood, appears to be particularly vulnerable to damage. It is also the source of 'pre-eclampsia biomarkers' such as sFlt-1 or placental growth factor (PlGF). It will be explained why these are, in fact, markers of syncytiotrophoblast damage. Changes in the circulating sFlt-1 and PlGF levels at term indicate that syncytiotrophoblast damage is an increasing feature of normal pregnancy. Moreover the pathology, visible only to electron microscopy reveals widespread syncytiotrophoblast damage. Evidence is presented that this results from diffuse placental hypoxia, which develops as the placenta outgrows the capacity of the uterus and its vasculature to support the increasing demands of the term placenta, Hence EO-PE and LO-PE both result from the same problem, malperfusion, which has very different causes.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
量子星尘发布了新的文献求助10
4秒前
自由的鹏涛完成签到,获得积分20
7秒前
8秒前
在水一方应助Nayvue采纳,获得10
8秒前
11秒前
Ryan完成签到,获得积分10
12秒前
General完成签到 ,获得积分10
12秒前
谦让汝燕完成签到,获得积分10
14秒前
wellyou完成签到,获得积分10
15秒前
mint完成签到,获得积分10
17秒前
afli完成签到 ,获得积分0
20秒前
21秒前
Yy完成签到 ,获得积分10
24秒前
Nayvue发布了新的文献求助10
26秒前
feng完成签到,获得积分10
26秒前
淡淡的小蘑菇完成签到 ,获得积分10
29秒前
G_Serron完成签到,获得积分10
30秒前
swordshine完成签到,获得积分10
30秒前
Anonymous完成签到,获得积分10
34秒前
medzhou完成签到,获得积分10
38秒前
儒雅的千秋完成签到,获得积分10
46秒前
普鲁卡因发布了新的文献求助10
49秒前
小雯完成签到,获得积分10
50秒前
搞怪梦寒完成签到,获得积分20
51秒前
喵了个咪完成签到 ,获得积分10
52秒前
mc完成签到 ,获得积分10
54秒前
量子星尘发布了新的文献求助10
57秒前
58秒前
58秒前
虚幻谷波完成签到,获得积分10
1分钟前
ruochenzu发布了新的文献求助10
1分钟前
小马甲应助搞怪梦寒采纳,获得10
1分钟前
firewood完成签到 ,获得积分10
1分钟前
天天快乐应助普鲁卡因采纳,获得10
1分钟前
orixero应助NXK采纳,获得10
1分钟前
bjr完成签到 ,获得积分10
1分钟前
研友_LwlAgn完成签到,获得积分10
1分钟前
陈昊完成签到,获得积分10
1分钟前
1分钟前
tian发布了新的文献求助10
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038128
求助须知:如何正确求助?哪些是违规求助? 3575831
关于积分的说明 11373827
捐赠科研通 3305610
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022