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Medizinische Universität Graz

PI, Mayer-Pickel

Novel strategies for prevention and therapy of high-risk pregnancies

 

Preeclampsia is a leading cause of mortality and morbidity during pregnancy and complicates up to 7% of pregnancies (1). Different mechanisms have been suggested to explain PE, including thrombosis, vascular and endothelial inflammation, or an imbalance of angiogenic and antiangiogenic placental factors. It is known fact that women with several autoimmune diseases such Antiphospholipid Syndrome and Systemic Lupus erythematodes are at increased risk of developing preeclampsia and/or HELLP-Syndrome (2, 3). In these pregnancies preeclampsia is often severe and might develop very early, even in the second trimester. Unfortunately, preeclampsia is still associated with a high risk of maternal and fetal/neonatal morbidity and mortality due to the limitation of several effective and causative therapeutic options. Expectant management in selected cases with early-onset preeclampsia has been reported being safe for the mother and beneficial for the child. However, one of the main questions in the management of early-onset preeclampsia is: what agents do we use to stabilize the mother in order to prolong the pregnancy? Several treatment options have been proposed (4): i.a. plasmapheresis, statins, metformin; all these therapeutical approaches are sought to decrease anti-inflammatory and anti-angiogenic factors and to improve endothelial dysfunction. Our aim is to investigate feasible novel strategies for prevention and treatment of several complications during pregnancy, especially anti-inflammatory therapy.

 

1. Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005;308:1592–1594. doi: 10.1126/science.1111726.

2. Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295-306. doi: 10.1111/j.1538-7836.2006.01753.x.

3. Clark EA, Silver RM, Branch DW. Do antiphospholipid antibodies cause preeclampsia and HELLP syndrome? Curr Rheumatol Rep. 2007;9:219-25.

4. Ornaghi S, Paidas MJ. Upcoming drugs for the treatment of preeclampsia in pregnant women. Expert Rev Clin Pharmacol. 2014 Sep;7(5):599-603. doi: 10.1586/17512433.2014.944501.

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