Abstract
Preeclampsia and intrauterine growth restriction are two separate disease entities that, according to numerous reports, share the same pathogenesis. In both, angiogenesis disorders and generalized inflammation are the dominant symptoms. In this study, we hypothesized that both diseases demonstrate the same profile in early preeclampsia, late preeclampsia, and intrauterine growth restriction patients, with the only difference being the degree of exacerbation of lesions. One hundred sixty-seven patients were enrolled in the study and divided into four groups: early preeclampsia, late preeclampsia, and intrauterine growth restriction groups, and one control group. Concentrations of the angiogenesis and inflammatory markers soluble fms-like tyrosine kinase receptor 1, placental growth factor, high-sensitivity C-reactive protein, and interleukin-6 were determined, and the behavior of these markers and correlations among them were studied. Higher concentrations of soluble fms-like tyrosine kinase receptor 1, high-sensitivity C-reactive protein, and interleukin-6 and a lower concentration of placental growth factor were observed in the study groups compared with the control group. No differences in concentrations of the studied markers were found among the study groups but significant correlations were observed. The higher values for the angiogenesis and inflammatory markers both in preeclampsia patients and patients with intrauterine growth restriction of placental origin compared with the control group suggest the existence of the same underlying disorders in the development of these pathologies. The observed mutual correlations for disordered angiogenesis and inflammatory markers are suggestive of a mutual relationship between these processes in the development of pathologies evolving secondary to placental ischemia. The same lesion profile was observed for both preeclampsia and ‘placental’ intrauterine growth restriction patients, which could be used in developing common diagnostic criteria for pregnant patients.
Highlights
Preeclampsia and intrauterine growth restriction (IUGR) are the main causes of perinatal morbidity and mortality
This study examined whether the pathologies related to impaired trophoblast invasion show similar disorders, which may indicate that they share the same pathogenesis
A statistical significant increase in the concentration of sFlt-1 was observed in the early preeclampsia group, the late preeclampsia group, and the group of patients with IUGR but without preeclampsia compared with the control group (p
Summary
Preeclampsia and intrauterine growth restriction (IUGR) are the main causes of perinatal morbidity and mortality. These diseases affect 6–10% of pregnant women in North America. Perfusion disorder in the uteroplacental compartment, is seen as the pathogenesis of these conditions. It appears that early preeclampsia, late preeclampsia, and some cases of IUGR share the same placental pathology but show different exacerbations and demonstrate different clinical pictures in the mother and fetus [1]. It is suggested that this group should perhaps be given one name, ‘ischemic placental syndrome’, and treated as a single pathology that presents different clinical pictures. Studies published to date indicate that a disordered blood supply to the placenta affects angiogenic, anti-angiogenic, and inflammatory factors synthesized by the placenta, and it is these factors that are responsible for the symptoms observed in the mother
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