Preeclampsia is a hypertensive disorder of pregnancy. It affects 2% to 8% of pregnancies worldwide and causes significant maternal and perinatal morbidity and mortality. Hypertension and proteinuria are the cornerstone of the disease, though systemic organ dysfunction may ensue. The clinical syndrome begins with abnormal placentation with subsequent release of antiangiogenic markers, mediated primarily by soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng). High levels of sFlt-1 and sEng result in endothelial dysfunction, vasoconstriction, and immune dysregulation, which can negatively impact every maternal organ system and the fetus. This review comprehensively examines the pathogenesis of preeclampsia with a specific focus on the mechanisms underlying the clinical features. Delivery is the only definitive treatment. Low-dose aspirin is recommended for prophylaxis in high-risk populations. Other treatment options are limited. Additional research is needed to clarify the pathophysiology, and thus, identify potential therapeutic targets for improved treatment and, ultimately, outcomes of this prevalent disease.

中文翻译：

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先兆子痫——病理生理学和临床表现

先兆子痫是妊娠期高血压疾病。它影响全球 2% 至 8% 的妊娠，并导致显着的孕产妇和围产期发病率和死亡率。高血压和蛋白尿是该疾病的基石，但可能会导致全身器官功能障碍。临床综合征始于胎盘异常，随后释放抗血管生成标志物，主要由可溶性 fms 样酪氨酸激酶-1 (sFlt-1) 和可溶性内皮糖蛋白 (sEng) 介导。高水平的 sFlt-1 和 sEng 会导致内皮功能障碍、血管收缩和免疫失调，这会对每个母体器官系统和胎儿产生负面影响。本综述全面研究了先兆子痫的发病机制，特别关注临床特征的潜在机制。分娩是唯一确定的治疗方法。建议在高危人群中使用低剂量阿司匹林进行预防。其他治疗选择是有限的。需要进一步的研究来阐明病理生理学，从而确定改善治疗的潜在治疗目标，并最终确定这种流行疾病的结果。