Editors' ChoiceEclampsia

Two Peas in a Pod

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Science Translational Medicine  23 Mar 2011:
Vol. 3, Issue 75, pp. 75ec38
DOI: 10.1126/scitranslmed.3002404

Eclampsia is a serious and sometimes life-threatening complication of pregnancy that can cause substantial harm to both the mother and baby. Moms-to-be with eclampsia experience severe seizures that can lead to fetal distress. Delivery is the only treatment for eclampsia; however, this is not a perfect solution because complications can continue to occur for the mother during labor, and early induction can lead to complications from prematurity. Thus, early diagnosis and management are key to preventing eclamptic seizures. It has been proposed that eclampsia may be a progression in severity from preeclampsia, in which patients have high blood pressure and protein in the urine. However, the mechanisms governing the development of eclampsia from preeclampsia, which could provide targets for disease prevention, remain poorly understood.

A recent study takes us one step closer to understanding the mechanisms behind this potentially devastating condition. Vaisbuch et al. examined the levels of three factors associated with severe preeclampsia to determine whether a similar imbalance was also observed among women who have eclampsia. To do so, they conducted a cross-sectional study comparing women with normal pregnancies to those with preeclampsia and eclampsia. Measurements were made of maternal circulating placental growth factor (PlGF), an angiogenic marker, in addition to soluble vascular endothelial growth factor receptor 1 (sVEGFR-1) and soluble endoglin (sEng), two antiangiogenic factors. The authors found that, compared with women with normal pregnancies, women with eclampsia had higher levels of sVEGFR-1 and sEng and lower levels of PlGF. No significant differences in these levels were observed between women with severe preeclampsia and those with eclampsia.

These data suggest that eclampsia and preeclampsia may be branches off a common event that takes place at the utero-placenta junction. Further understanding the causes of these conditions should help us develop new therapies to manage or even prevent preeclampsia and eclampsia in pregnant women.

E. Vaisbuch et al., Circulating angiogenic and antiangiogenic factors in women with eclampsia. Am. J. Obstet. Gynecol. 204, 152.e1–152.e9 (2011). [PubMed]

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