The placenta and preeclampsia: Villain or victim?

For many years, researchers have argued that preeclampsia is a clinical syndrome of the placenta resulting from an immune response to the foreign organ. The theory is that preeclampsia typically presents with symptoms affecting the blood vessels, such as hypertension, proteinuria, and organ dysfunction, but is actually the result of earlier inflammation, endothelial damage (damage that affects the interior lining of the blood vessels), and reduced blood flow to vital organs.

This research article asks the question: is the placenta the reason preeclampsia occurs, or is it just one more organ affected by an underlying cardiovascular disease? The authors make the argument that preeclampsia could be caused by an underlying cardiovascular disease which is not yet fully understood, with the placental issues only being a secondary effect (along with other organs). Proposing that preeclampsia starts with cardiovascular issues could then influence how preeclampsia screening, diagnostic and prevention strategies would be managed by a woman’s care providers. Given the annual impact the disease has on pregnancies in the US and globally, this viewpoint could help increase focus on prevention strategies.

Take home message:  A clear understanding and acceptance of the role of the cardiovascular system in preeclampsia is needed.

Link: https://www.ajog.org/article/S0002-9378(20)31198-4/fulltext

About Research Roundup

Each quarter, our team of researchers reviews the most current studies related to hypertensive disorders of pregnancy and selects those studies they feel will be of greatest interest to our community to summarize.

Special thanks to our volunteer research team, who under the leadership of Dr. Elizabeth Sutton, make Research Roundup possible: Alisse Hauspurg, MD Felicia LeMoine, MD Jenny Sones, PhD, DVM, and Robin Trupp, PhD, RN.