Hypertension in pregnancy: Taking cues from pathophysiology for clinical practice

Clinical Cardiology
Ruxandra I SavaCarl J Pepine

Abstract

Pregnancy-related hypertension (PHTN) syndromes are a frequent and potentially deadly complication of pregnancy, while also negatively impacting the lifelong health of the mother and child. PHTN appears in women likely to develop hypertension later in life, with the stress of pregnancy unmasking a subclinical hypertensive phenotype. However, distinguishing between PHTN and chronic hypertension is essential for optimal management. Preeclampsia (PE) is linked to potentially severe outcomes and lacks effective treatments due to poorly understood mechanisms. Inadequate remodeling of spiral uterine arteries (SUAs), the cornerstone of PE pathophysiology, leads to hypoperfusion of the developing placenta. In normal pregnancies, extravillous trophoblast (EVT) cells assume an invasive phenotype and invade SUAs, transforming them into large conduits. Decidual natural killer cells play an essential role, mediating materno-fetal immune tolerance, inducing early SUA remodeling and regulating EVT invasiveness. Notch signaling is important in EVT phenotypic switch and is dysregulated in PE. The hypoxic placenta releases antiangiogenic and proinflammatory factors that converge upon maternal endothelium, inducing endothelial dysfunction, hypert...Continue Reading

References

Nov 1, 1989·American Journal of Obstetrics and Gynecology·J M RobertsM K McLaughlin
Jan 26, 2002·American Journal of Obstetrics and Gynecology·Alan BuchbinderUNKNOWN National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units
Oct 13, 2004·The Journal of Experimental Medicine·Susan E HibyAshley Moffett
Feb 14, 2009·Journal of Anatomy·Berthold HuppertzGerit Moser
Apr 8, 2009·The American Journal of Pathology·Samantha D SmithRebecca L Jones
Jun 1, 2010·The Journal of Immunology : Official Journal of the American Association of Immunologists·Soufiane GhannamHans Yssel
Jul 6, 2011·Tissue Antigens·M InngjerdingenJ T Vaage
Nov 30, 2012·BJOG : an International Journal of Obstetrics and Gynaecology·K MelchiorreB Thilaganathan
Feb 26, 2013·Journal of Reproductive Immunology·Melinda Halasz, Julia Szekeres-Bartho
Sep 10, 2013·Journal of Reproductive Immunology·Audrey F SaftlasElizabeth W Triche
Oct 10, 2013·The American Journal of Pathology·Alison E WallaceJudith E Cartwright
Jan 31, 2014·Current Atherosclerosis Reports·Amanda R Vest, Leslie S Cho
Mar 19, 2014·Circulation·Ellen W Seely, Jeffrey Ecker
Jul 6, 2014·Journal of Pregnancy·Kjell HaramBálint Nagy
Aug 20, 2014·Obstetrics and Gynecology International·Leona C Poon, Kypros H Nicolaides
Dec 30, 2014·Trends in Molecular Medicine·Styliani Goulopoulou, Sandra T Davidge
Jan 30, 2015·The New England Journal of Medicine·Laura A MageeJean-Marie Moutquin
Oct 19, 2016·Reproductive Biomedicine Online·Ashley MoffettMartin H Johnson
Apr 13, 2017·Acta Obstetricia Et Gynecologica Scandinavica·Elena R Magro-MalossoVincenzo Berghella
Oct 4, 2017·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·R OrabonaT Frusca
Oct 19, 2017·Drugs·A AtallahV Tsatsaris
Oct 19, 2017·Clinical Science·Jamil ElfarraDenise C Cornelius
Nov 15, 2017·Hypertension·Agnès DitisheimAntoinette Pechère-Bertschi
Feb 9, 2018·Obstetrics and Gynecology·Kirsten L ClearyAlexander M Friedman

❮ Previous
Next ❯

Citations

Nov 22, 2018·Reproductive Sciences·Sara Z GomesEstela Bevilacqua
Jun 10, 2018·Current Hypertension Reports·Eman Y Gohar, David M Pollock
Aug 1, 2020·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Philippe VangriekenPaul M H Schiffers
Sep 6, 2020·International Journal of Obesity : Journal of the International Association for the Study of Obesity·María PeralesAlejandro Lucia
Sep 3, 2020·Revista Do Instituto De Medicina Tropical De São Paulo·Yao WenlingShi Ouyang
May 6, 2019·Reproductive Toxicology·Julia VarshavskyTracey J Woodruff
Aug 10, 2021·The EPMA Journal·Adriana Torres CrignaOlga Golubnitschaja
Jan 13, 2022·Biology of Reproduction·Faten AbdelHafez AhmedPeter C K Leung

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cancer Biology: Molecular Imaging

Molecular imaging enables noninvasive imaging of key molecules that are crucial to tumor biology. Discover the latest research in molecular imaging in cancer biology in this feed.

Related Papers

Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre
Raj Raghupathy
Médecine sciences : M/S
Céline MéhatsDaniel Vaiman
© 2022 Meta ULC. All rights reserved