Pre-eclampsia

Pre-eclampsia

Pre-eclampsia is a multi-systemic disorder characterised by hypertension (high blood pressure) and proteinuria (the presence of protein in urine). It has been the leading cause of maternal mortality in the UK over recent decades. Worldwide the disease is responsible for approximately 150,000 deaths per year. Pre-eclampsia also leads to considerable mortality and morbidity in newborn children and can carry health implications in adult life, including increased risk of hypertension, heart disease and diabetes.

Examination of the placenta from normal and pre-eclamptic pregnancies has revealed that pre-eclampsia is associated with an apparent failure of trophoblast cells to invade and remodel the maternal environment. A failure to remodel the maternal spiral arteries, for example, is thought to restrict the blood flow to the developing foetus and may be a contributing factor to the onset of pre-eclampsia.

There are a number of reasons for the failure of trophoblasts to perform their normal function during pre-eclamptic pregnancies. For example, an increased incidence of trophoblast cell death (apoptosis) has been detected in these pregnancies. It is also possible that the motility and invasiveness of trophoblast cells is compromised. Our research aims to investigate the factors, such as nitric oxide, that regulate trophoblast function in order to determine how and why some pregancies are complicated with pre-eclampsia.

 

Doppler Ultrasound

It is widely accepted that PE pathology begins in early pregnancy as this is the time point at which uterine spiral arteries are remodelled to accommodate the increase in blood flow to the uterus and growing fetus. Uterine artery Doppler ultrasound can be used to identify first-trimester pregnancies at most risk of developing early-onset PE. An association has been shown between a high uterine artery Doppler resistance index, combined with bilateral uterine artery notching, and reduced extravillous trophoblast invasion of the uterine spiral arteries and the later development of early-onset PE. Our laboratory is interested in using this tool in order to examine different cell types from pregnancies at highest and least risk of pre-eclampsia.

 

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