Can We Predict Preeclampsia?

Abstract

Hypertensive disorders in pregnancy are a leading cause of peripartum morbidity and mortality. Preeclampsia is a heterogeneous maternal syndrome. Large studies have pointed out the association of impaired spiral artery remodeling at the fetomaternal interphase in preeclampsia, but how exactly is the fetomaternal dialogue mediated and what are the biomarkers to detect the subclinical disease in various subsets of high-risk pregnancies is still a challenge. These biomarkers can finally be used to diagnose renal function (Kallikrein-creatinine ratio), vascular resistance (uterine artery Doppler), coagulation disorders (platelet volume, fibronectin, prostacyclin, thromboxane, oxidant stress (lipid peroxidase, 8-isoprostane, antioxidants, anticardiolipin antibodies, homocysteine, serum uric acid), vascular adaptation (Placental growth factor, Vascular endothelial growth factor, s flut, s eng) and markers of placental function and ischemia (placental CRH, CRH bp, activin, inhibin,hCG).Post partum preeclampsia can be predicted by identifying the factors preventing the excretion of sodium, puerperal diuresis  and shift of intravascular fluid into the extra vascular compartment compartment(atrial natriuretic peptide in the first week after delivery, natriuresis and inhibition of aldosterone, angiotensin II, vasopressin)