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The Influence of Various Smoking Categories on The Risk of Gestational Hypertension and Pre-Eclampsia
Open AccessReview

Preeclampsia Is a Syndrome with a Cascade of Pathophysiologic Events

1
Department Obstetrics, Ziekenhuis Oost Limburg, B3600 Genk, Belgium
2
Department Physiology, Hasselt University, B3590 Diepenbeek, Belgium
J. Clin. Med. 2020, 9(7), 2245; https://doi.org/10.3390/jcm9072245
Received: 1 June 2020 / Revised: 5 July 2020 / Accepted: 13 July 2020 / Published: 15 July 2020
This review integrates the currently available information on the molecular, cellular, and systemic mechanisms involved in the pathophysiology of preeclampsia. It highlights that the growth, protection, and promotion of the conceptus requires the modulation of an intact maternal immune system, communication between the mother and fetus, and adaptation of the maternal organic functions. A malfunction in any of these factors, on either side, will result in a failure of the cascade of events required for the normal course of pregnancy. Maladaptive processes, initially aiming to protect the conceptus, fail to anticipate the gradually increasing cardiovascular volume load during the course of pregnancy. As a result, multiple organ dysfunctions install progressively and eventually reach a state where mother and/or fetus are at risk of severe morbidity or even mortality, and where the termination of pregnancy becomes the least harmful solution. The helicopter view on pathophysiologic processes associated with preeclampsia, as presented in this paper, illustrates that the etiology of preeclampsia cannot be reduced to one single mechanism, but is to be considered a cascade of consecutive events, fundamentally not unique to pregnancy. View Full-Text
Keywords: preeclampsia; gestational physiology; pathophysiology; inflammation; immune tolerance; extracellular vesicles; maternal hemodynamics; venous hemodynamics; venous congestion; intra-abdominal pressure preeclampsia; gestational physiology; pathophysiology; inflammation; immune tolerance; extracellular vesicles; maternal hemodynamics; venous hemodynamics; venous congestion; intra-abdominal pressure
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MDPI and ACS Style

Gyselaers, W. Preeclampsia Is a Syndrome with a Cascade of Pathophysiologic Events. J. Clin. Med. 2020, 9, 2245.

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