Xxiv международная медико-биологическая конференция молодых исследователей Фундаментальная наука и клиническая

ETIOPATHOGENESIS 
OF PREECLAMPSIA AND ECLAMPSIA
Harak K., M.D. student, demonstrator
Department of Pathophysiology, School of Medicine University of Zagreb, 
University Hospital Centre, KBC Rebro. 
Zagreb, Croatia 
Acad. Supervisor: Prof. Z. Kovač, M.D., Ph.D., Chairman of Dept.
Introduction. 
Gestoses are diseases of pregnancy characterized by 
edema, proteinuria and hypertension. When the patient's condition 
with these symptoms progresses to disorders of the central nervous 
system and tonic-clonic cramps, a clinical presentation is classified as 
pre-eclampsia/eclampsia syndrome. Unrecognized and untreated, pre-
eclampsia and eclampsia may lead to a significant increase in morbidity 
and mortality of pregnant women. The condition causes more than 
50,000 deaths worldwide every year. Numerous clinical conditions can 
mimic pre-eclampsia and eclampsia and further hinder the diagnosis 
of the disease. During last 20 years, numerous molecular mechanisms 
have been investigated and described as mediators of the disease. This 
analysis compresses previous knowledge and research on pre-eclampsia 
and eclampsia and gives a broad overview of mechanisms of formation 
of placental defects and angiogenic factors as potential biomarkers for 
earlier diagnosis of the disease. 
Methods and materials. 
This overview is based on PubMed-reached 
12 papers with references from more than 750 original CWI articles. 
Those referenced papers contain quantitative and some qualitative studies, 
whose overall summary is presented here as a narrative overview. Results 
and discussion. In addition to numerous genetic, environmental and 
immunological factors that lead to reduced placental perfusion, as the main 
molecular mediators of endothelial dysfunction that consequently leads 
to proteinuria, hypertension and coagulation disorders are antiangiogenic 
factors sFlt-1 and sEng whose increased concentration has been observed 
in women with pre-eclampsia and eclampsia. The leading cause of death 
in patients is brain hemorrhage, and a more severe clinical picture is the 
risk for developing hypertension, ischemic myocardial disease, stroke and 

---

5
TH
ISP SYMPOSIUM ON CLINICAL PATHOPHYSIOLOGY
947
venous thromboembolism in patients later in life. As a result of increase 
in antiangiogenic factors (
↑
sFlt-1 and thus ratio PlGF/sFlt-1 < 0,033), 
there is decrease in the concentration of angiogenic factors (VEGF, PlGF, 
TGF-β) that are responsible for normal placentation and maintenance 
of vascular continuity in placenta and other organs. Other potential 
mediators of pre-eclampsia and eclampsia are urotensine (serum UII > 
31,6 pg/ml), non-coding RNA molecules (miRNA) and ANP, which are 
mostly related to high blood pressure in patients with mild and severe 
eclampsia.