ROLE OF ANGIOGENIC FACTORS IN THE MANAGEMENT OF PRE-ECLAMPSIA.

Abstract

Preeclampsia is a pregnancy disorder causing different maternal and fetal morbidity and mortality. Currently the diagnosis is based upon the new onset of hypertension and proteinuria. There is strong clinical need for increased screening to avoid unnecessary resource use and for better outcomes. The angiogenic factors placental growth factor, soluble fms?like tyrosine kinase 1 and soluble endoglin, all originating at least in part from the syncytiotrophoblast, are biomarkers with predictive potential for preeclampsia and related adverse outcomes. Recent work with the soluble fms?like tyrosine kinase 1/placental growth factor ratio has identified key measurement cutoffs, with one having a high negative predictive value for preeclampsia. The two-stage theory and angiogenic imbalance are two notable postulates of the disease. Together, they propose that there is a lack of cytotrophoblastic invasion of the uterine spiral arteries in pre-eclampsia. The lumen of these arteries remains narrow instead of converting to the wide channels seen in normal pregnancy, and result in poor placental perfusion. Coupled with maternal susceptibility, this process leads to the release of mediators, including an excess of anti-angiogenic factors that result in the clinical manifestations of the disease.
Current review explains the role of angiogenic factors in the pathogenesis and management of pre-eclampsia
Keywords: Angiogenic factors, management of pre-eclampsia, pregnancy, placental growth factors.