Preeclampsia: Biological and Clinical Aspects

Preeclampsia is a complication associated with pregnancy due to an abnormal formation of placental blood vessels. Though the reason for occurrence is unclear, recent studies have enabled us to understand the pathophysiology of the condition, which has eventually improved its management. Multiple risk factors are believed to contribute to poor placentation, which includes chronic hypertension, antiphospholipid antibody syndrome, pre-gestational diabetes, chronic renal disease, previous intrauterine growth restriction, and previous placental abruption. Understanding preeclampsia at both biological and clinical levels is crucial for a proper diagnosis. Abnormally elevated plasma levels of MMP7, sFlt1, sEng, PAPP-A, VEGF, PIGF, activin A, and cell-free fetal DNA can serve as maternal markers for preeclampsia. It has been widely accepted that these changes in the plasms levels would complicate the natural course of pregnancies. Certain classical features like hypertension and proteinuria still remain the best indicators of preeclampsia. An abnormal hematological profile in preeclampsia is known to be associated with certain coagulopathies, such as disseminated intravascular coagulation. In the current chapter, we discuss both biological and clinical aspects of preeclampsia.