Epidural-associated hypotension is more common among severely preeclamptic patients in labor

Multisystem Effects of Hypertensive Disorders of Pregnancy: A Comprehensive Review

Hypertension predisposes the woman and fetus to adverse outcomes during the pregnancy and postpartum. The risk for maternal complications and neonatal morbidity associated with the necessity of preterm birth extends beyond the postpartum and postnatal period. A comprehensive review of the multisystem effects of hypertensive disorders and underlying pathophysiology is provided to support the role of prompt identification of and management of acute complications of hypertension.

Preeclampsia-like symptoms induced in mice by fetoplacental expression of STOX1 are reversed by aspirin treatment

Preeclampsia (PE) is a common human-specific pregnancy disorder defined by hypertension and proteinuria during gestation and responsible for maternal and fetal morbimortality. STOX1, encoding a transcription factor, was the first gene associated with PE as identified by positional cloning approaches. Its overexpression in choriocarcinoma cells mimics the transcriptional consequences of PE in the human placenta. Here, we created transgenic mouse strains overexpressing human STOX1. Wild-type female mice crossed with transgenic male mice reproduce accurately the symptoms of severe PE: gestational hypertension, proteinuria, and elevated plasma levels of soluble fms-like tyrosine kinase 1 and soluble endoglin. Placental and kidney histology were altered. Symptoms were prevented or alleviated by aspirin treatment. STOX1-overexpressing mice constitute a unique model for studying PE, allow testing therapeutic approaches, and assessing the long-term effects of the preeclamptic syndrome.