What is the pathophysiology of preeclampsia?

Updated: Nov 29, 2018
  • Author: Kee-Hak Lim, MD; Chief Editor: Ronald M Ramus, MD  more...
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Answer

Answer

As previously mentioned, preeclampsia is characterized by endothelial dysfunction in pregnant women. Therefore, the possibility exists that preeclampsia may be a contributor to future cardiovascular disease. In a meta-analysis, several associations were observed between an increased risk of cardiovascular disease and a pregnancy complicated by preeclampsia. These associations included an approximately 4-fold increase in the risk of subsequent development of hypertension and an approximately 2-fold increase in the risk of ischemic heart disease, venous thromboembolism, and stroke. [18] Moreover, women who had recurrent preeclampsia were more likely to suffer from hypertension later in life. [18]

In a review of population-based studies, Harskamp and Zeeman noted a relationship between preeclampsia and an increased risk of later chronic hypertension and cardiovascular morbidity/mortality, compared with normotensive pregnancy. Moreover, women who develop preeclampsia before 36 weeks' gestation or who have multiple hypertensive pregnancies were at highest risk. [19]

A prospective observational study by Vaught that included 63 women with pre-eclampsia with severe features reported higher systolic pressure, higher rates of abnormal diastolic function, decreased global right ventricular longitudinal systolic strain, increased left-sided chamber remodeling, and higher rates of peripartum pulmonary edema in these women when compared with healthy pregnant women. [112]


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