Imperial College London
Alternate

Dr Jasmine Tay

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3313 7316j.tay14

 
 
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Location

 

Queen Charlottes and Chelsea HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Masini:2022:10.1016/j.ajog.2020.10.052,
author = {Masini, G and Foo, LF and Tay, J and Wilkinson, IB and Valensise, H and Gyselaers, W and Lees, CC},
doi = {10.1016/j.ajog.2020.10.052},
journal = {American Journal of Obstetrics and Gynecology},
pages = {S1006--S1018},
title = {Preeclampsia has two phenotypes which require different treatment strategies},
url = {http://dx.doi.org/10.1016/j.ajog.2020.10.052},
volume = {226},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - The opinion on the mechanisms underlying the pathogenesis of preeclampsia still divides scientists and clinicians. This common complication of pregnancy has long been viewed as a disorder linked primarily to placental dysfunction, which is caused by abnormal trophoblast invasion, however, evidence from the previous two decades has triggered and supported a major shift in viewing preeclampsia as a condition that is caused by inherent maternal cardiovascular dysfunction, perhaps entirely independent of the placenta. In fact, abnormalities in the arterial and cardiac functions are evident from the early subclinical stages of preeclampsia and even before conception. Moving away from simply observing the peripheral blood pressure changes, studies on the central hemodynamics reveal two different mechanisms of cardiovascular dysfunction thought to be reflective of the early-onset and late-onset phenotypes of preeclampsia. More recent evidence identified that the underlying cardiovascular dysfunction in these phenotypes can be categorized according to the presence of coexisting fetal growth restriction instead of according to the gestational period at onset, the former being far more common at early gestational ages. The purpose of this review is to summarize the hemodynamic research observations for the two phenotypes of preeclampsia. We delineate the physiological hemodynamic changes that occur in normal pregnancy and those that are observed with the pathologic processes associated with preeclampsia. From this, we propose how the two phenotypes of preeclampsia could be managed to mitigate or redress the hemodynamic dysfunction, and we consider the implications for future research based on the current evidence. Maternal hemodynamic modifications throughout pregnancy can be recorded with simple-to-use, noninvasive devices in obstetrical settings, which require only basic training. This review includes a brief overview of the methodologies and techniques used to study hemody
AU  - Masini,G
AU  - Foo,LF
AU  - Tay,J
AU  - Wilkinson,IB
AU  - Valensise,H
AU  - Gyselaers,W
AU  - Lees,CC
DO  - 10.1016/j.ajog.2020.10.052
EP  - 1018
PY  - 2022///
SN  - 0002-9378
SP  - 1006
TI  - Preeclampsia has two phenotypes which require different treatment strategies
T2  - American Journal of Obstetrics and Gynecology
UR  - http://dx.doi.org/10.1016/j.ajog.2020.10.052
UR  - http://hdl.handle.net/10044/1/97036
VL  - 226
ER  -
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