Preeclampsia in modern conditions

Baranovskaya А.I.

Belarusian State Medical University, Minsk, Belarus
The data available in the scientific literature on the current solution of individual tasks in the problem of preeclampsia were analyzed. Soluble fms-like tyrosine kinase-1 (sFlt-1) and angiogenic growth factors were established to play a role in the pathogenesis of preeclampsia. Severe or progressive preeclampsia becomes an indication for delivery, regardless of gestational age. It is recommended that all countries should use magnesium sulfate to prevent and treat eclampsia and corticosteroids for women at risk of preterm pregnancy to prevent neonatal complications. The long-term consequences of preeclampsia are cardiovascular disease and death due to this condition. The study provided a scientific knowledge of the importance of angiogenic factors in the pathogenesis of preeclampsia. The diagnostic criteria of preeclampsia are specified, but there are still problems in the management of this pathology.




1. Von Dadelszen P., Sawchuck D., Hofmeyr G.J., Magee L.A., Bracken H.,Mathai M. et al. PRE-EMPT (PRE-eclampsia–Eclampsia Monitoring, Prevention and Treatment): A low and middle income country initiative to reduce the global burden of maternal, fetal and infant death and disease related to pre-eclampsia. Pregnancy Hypertens. 2013; 3(4): 199–202.

2. Tranquilli A.L., Dekker G., Magee L., Roberts J., Sibai B.M., Steyn W. et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens. 2014; 4(2): 97–104.

3. Magee L.A., Pels A., Helewa M., Rey E., von Dadelszen P. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertens. 2014; 4(2): 105–45.

4. Сидорова И.С., Никитина Н.А. Научно обоснованная система прогнозирования преэклампсии. Акушерство и гинекология. 2017; 3: 55–61. [Sidorova I.S., Nikitina N.A. Nauchno obosnovannaya sistema prognozirovaniya preeklampsii. Akusherstvo i ginekologiya / Obstetrics and gynecology. 2017; 3: 55–61.–61. (in Russian)].

5. Башмакова Н.В., Цывьян П.Б., Чистякова Г.Н., Пестряева Л.А., Гагарина Е.М. Ангиогенные ростовые факторы и патогенез преэклампсии. Российский вестник акушера-гинеколога. 2017; 17(5): 7–12. [Bashmakova N.V., Tsyivyan P.B., Chistyakova G.N., Pestryaeva L.A., Gagarina E.M. Angiogennyie rostovyie faktoryi i patogenez preeklampsii. Rossiyskiy vestnik akushera-ginekologa / The Russian bulletin of the obstetrician-gynecologist. 2017; 5: 7–12. (in Russian)].

6. Zeisler H., Llurba E., Chantraine F., Vatish M., Staff A.C., Sennström M. et al. Predictive value of the sFlt-1:PlGF ratio in women with suspected preeclampsia. N. Engl. J. Med. 2016; 374(1): 13–22.

7. Cheng Y.K.Y., Law L.W., Leung T.Y., Chan O.K., Sahota D.S. Soluble fms-like tyrosine kinase-1, placental growth factor and their ratio as a predictor for pre-eclampsia in East Asians. Pregnancy Hypertens. 2018; 11: 61–5.

8. Bazzano A.N., Green E., Madison A., Barton A., Gillispie V., Bazzano L.A.L. Assessment of the quality and content of national and international guidelines on hypertensive disorders of pregnancy using the AGREE II instrument. BMJ Open. 2016; 6(1): e009189.

9. Hutcheon J.A., Lisonkova S., Joseph K.S. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract. Res. Clin. Obstet. Gynaecol. 2011; 25(4): 391–403.

10. Black C., da Silva Costa F. Biomarker immunoassays in the diagnosis of preeclampsia: calculating the sFlt1/PlGF ratio using the Cobas®e 411 analyser. Methods Mol. Biol. 2018; 1710: 9–26.

11. Churchill D., Duley L., Thornton J.G., Jones L. Interventionist versus expectant care for severe pre-eclampsia between 24 and 34 weeks’ gestation. Cochrane Database Syst. Rev. 2013; (7): CD003106.

12. Salam R.A., Das J.K., Ali A., Bhaumik S., Lassi Z.S. Diagnosis and management of preeclampsia in community settings in low and middle-income countries. J. Fam. Med. Primary Care. 2015; 4(4): 501–6.

13. Nakanishi S., Aoki S., Nagashima A., Seki K. Incidence and pregnancy outcomes of superimposed preeclampsia with or without proteinuria among women with chronic hypertension. Pregnancy Hypertens. 2017; 7: 39–43.

14. Волков В.Г., Гранатович Н.Н., Сурвилло Е.В., Черепенко О.В. Ретроспективный анализ материнской смертности от преэклампсии и эклампсии. Российский вестник акушера-гинеколога. 2017; 17(3): 4–8. [Volkov V.G., Granatovich N.N., Survillo E.V., Cherepenko O.V. Retrospektivnyiy analiz materinskoy smertnosti ot preeklampsii i eklampsii. Rossiyskiy vestnik akushera-ginekologa / The Russian bulletin of the obstetrician-gynecologist. 2017; 3: 4–8. (in Russian)].

15. Сидорова И.С., Милованов А.П., Никитина Н.А., Бардачова А.В., Рзаева А.А. Тяжелая преэклампсия и эклампсия – критические состояния для матери и плода. Акушерство и гинекология. 2013; 12: 34–40. [Sidorova I.S., Milovanov A.P., Nikitina N.A., Bardachova A.V., Rzaeva A.A. Tyazhelaya preeklampsiya i eklampsiya – kriticheskie sostoyaniya dlya materi i ploda. Akusherstvo i ginekologiya / Obstetrics and gynecology. 2013; 12: 34–40. (in Russian)].

16. Сидорова И.С., Филиппов О.С., Никитина Н.А., Гусева Е.В. Причины материнской смертности от преэклампсии и эклампсии в 2013 году. Акушерство и гинекология. 2015; 4: 11–7. [Sidorova I.S., Filippov O.S., Nikitina N.A., Guseva E.V. Prichinyi materinskoy smertnosti ot preeklampsii i eklampsii v 2013 godu. Akusherstvo i ginekologiya / Obstetrics and gynecology. 2015; 4: 11–17. (in Russian)].

17. Members T.F., Mancia G., Fagard R., Narkiewicz K., Redon J., Zanchetti A. et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur. Heart J. 2013; 34(28): 2159–219.

18. Knight M.; UKOSS. Eclampsia in the United Kingdom 2005. BJOG. 2007; 114(9): 1072–8.

19. Duley L., Henderson-Smart D.J., Walker G.J., Chou D. Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst. Rev. 2010; (12): CD000127.

20. WHO Recommendations for prevention and treatment of pre-eclampsia and eclampsia. Geneva, Switzerland: World Health Organization; 2014. Available at: Accessed 02.02.2018.

21. Brown M.C., Best K.E., Pearce M.S., Waugh J., Robson S.C., Bell R. Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis. Eur. J. Epidemiol. 2013; 28(1): 1–19.

22. Ayansina D., Black C., Hall S.J., Marks A., Millar C., Prescott G.J. et al. .Long term effects of gestational hypertension and pre-eclampsia on kidney function: Record linkage study. Pregnancy Hypertens. 2016; 6(4): 344–9.

23. Tooher J., Thornton C., Makris A., Ogle R., Korda A., Horvath J. et al. Hypertension in pregnancy and long-term cardiovascular mortality: a retrospective cohort study. Am. J. Obstet. Gynecol. 2016; 214(6): 722. e1–6.

24. Skjaerven R., Wilcox A.J., Klungsøyr K., Irgens L.M., Vikse B.E., Vatten L.J. et al. Cardiovascular mortality after pre-eclampsia in one child mothers: prospective, population based cohort study. BMJ. 2012; 345: e7677.

25. Riise H.K., Sulo G., Tell G.S., Igland J., Nygård O., Vollset S.E. et al. Incident coronary heart disease after preeclampsia: role of reduced fetal growth, preterm delivery, and parity. J. Am. Heart Assoc. 2017; 6(3): e004158.

Received 19.02.2018

Accepted 02.03.2018

About the Authors

Baranovskaya, Alena I., Doctor of Medicine, Professor. Professor of the Department of Obstetrics and Gynecology at the Belarusian State Medical University.
220005, ul. Krasnaya, 17–A, 34, Minsk, Belarus.–0002–2116–4675

For citations: Baranovskaya E.I. Preeclampsia in modern conditions.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (11): 5-9. (in Russian)

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.