Cardiovascular Journal of Africa: Vol 27 No 2 (March/April 2016)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 2, March/April 2016

AFRICA

Conclusion

The exact aetiology of PE remains elusive but much of the

pathophysiology has been explained. The current theory is one

of balance between angiogenic and anti-angiogenic factors.

Measurement of circulatory angiogenic and anti-angiogenic

proteins as biomarkers could possibly indicate placental

dysfunction and differentiate PE from other disorders, such as

gestational hypertension and chronic glomerulonephritis. In

addition, biomarkers such as those stated above are reproducible,

linked to the disease, and above all, are easy to interpret.

See Fig. 1 for some aspects of the pathophysiology of

pre-eclampsia.

Key messages

• The exact aetiology of pre-eclampsia remains elusive.

• Much of the pathophysiology has been explained.

• Treatment remains empirical and cure is dependent on stabilisa-

tion of high blood pressure and other specific organ complications,

followed by delivery of the foetus and placenta.

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uNKC

Placental ischaemia

Defective spiral

artery remodelling

Cytotrophoblasts Genetic factors

↑

sFlt-1

Endothelial

dysfunction

Glomerular

endotheliosis

Hypoxia–reperfusion

damage of

trophoblasts

HYPERTENSION,

PROTEINURIA,

OEDEMA

Pulsatile/

intermittent

blood flow

to placenta

STMBs, cytokines,

AT-1AA, imbalance

in angiogenic–anti-

angiogenic factors in

maternal circulation

↓

VEGF, PlGF

PRE-ECLAMPSIA

Fig. 1.

Aspects of pathophysiology of pre-eclampsia. VEGF:

vascular endothelial growth factor; PlGF: placental

growth factor; sFlt-1: soluble film-like tyrosine kinase.