Gathiram P, Moodley J
Department of Physiology, Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Department of Obstetrics and Gynaecology and Women's Health and HIV Research Group, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. Email:
Cardiovasc J Afr. 2016 Mar-Apr;27(2):71-8. doi: 10.5830/CVJA-2016-009.
Pre-eclampsia is a pregnancy-specific disorder that has a worldwide prevalence of 5-8%. It is one of the main causes of maternal and perinatal morbidity and mortality globally and accounts for 50 000-60 00 deaths annually, with a predominance in the low- and middle-income countries. It is a multi-systemic disorder however its aetiology, pathogenesis and pathophysiology are poorly understood. Recently it has been postulated that it is a two-stage disease with an imbalance between angiogenic and anti-antigenic factors. This review covers the latest thoughts on the pathogenesis and pathology of pre-eclampsia. The central hypothesis is that pre-eclampsia results from defective spiral artery remodelling, leading to cellular ischaemia in the placenta, which in turn results in an imbalance between anti-angiogenic and pro-angiogenic factors. This imbalance in favour of anti-angiogenic factors leads to widespread endothelial dysfunction, affecting all the maternal organ systems. In addition, there is foetal growth restriction (FGR). The exact aetiology remains elusive.
子痫前期是一种与妊娠相关的疾病，全球患病率为5%-8%。它是全球孕产妇和围产期发病及死亡的主要原因之一，每年导致5万至6万人死亡，在低收入和中等收入国家更为常见。它是一种多系统疾病，但其病因、发病机制和病理生理学仍知之甚少。最近有人提出，它是一种两阶段疾病，血管生成因子和抗血管生成因子之间存在失衡。本综述涵盖了子痫前期发病机制和病理学的最新观点。核心假说是子痫前期是由螺旋动脉重塑缺陷导致胎盘细胞缺血引起的，进而导致抗血管生成因子和促血管生成因子之间失衡。这种有利于抗血管生成因子的失衡导致广泛的内皮功能障碍，影响所有母体器官系统。此外，还存在胎儿生长受限（FGR）。确切病因仍不清楚。
