Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Rev Bras Ginecol Obstet. 2022 Aug;44(8):771-775. doi: 10.1055/s-0042-1743100. Epub 2022 Jul 11.
Preeclampsia, a human pregnancy syndrome, is characterized by elevated blood pressure and proteinuria after the 20th week of gestation. Its etiology remains unknown, and its pathophysiological mechanisms are related to placental hypoperfusion, endothelial dysfunction, inflammation, and coagulation cascade activation. Recently, the role of the complement system has been considered. This syndrome is one of the main causes of maternal and fetal mortality and morbidity. This article discusses the hypothesis of preeclampsia being triggered by the occurrence of inadequate implantation of the syncytiotrophoblast, associated with bleeding during the first stage of pregnancy and with augmented thrombin generation. Thrombin activates platelets, increasing the release of antiangiogenic factors and activating the complement system, inducing the membrane attack complex (C5b9). Immature platelet fraction and thrombin generation may be possible blood biomarkers to help the early diagnosis of preeclampsia.
子痫前期是一种人类妊娠综合征，其特征是在妊娠 20 周后血压升高和蛋白尿。其病因仍不清楚，其病理生理机制与胎盘灌注不足、内皮功能障碍、炎症和凝血级联激活有关。最近，补体系统的作用也受到了关注。这种综合征是导致孕产妇和胎儿死亡率和发病率的主要原因之一。本文讨论了子痫前期是由合胞滋养层植入不足引起的假说，这种植入不足与妊娠早期出血有关，与凝血酶生成增加有关。凝血酶激活血小板，增加抗血管生成因子的释放，并激活补体系统，诱导膜攻击复合物（C5b9）。未成熟血小板分数和凝血酶生成可能是有助于子痫前期早期诊断的血液生物标志物。
