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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. Nov 10, 2015; 4(4): 77-85
Published online Nov 10, 2015. doi: 10.5317/wjog.v4.i4.77
Preeclampsia - What is to blame? The placenta, maternal cardiovascular system or both?
Dimuthu Vinayagam, Karin Leslie, Asma Khalil, Baskaran Thilaganathan
Dimuthu Vinayagam, Karin Leslie, Asma Khalil, Baskaran Thilaganathan, Fetal Maternal Medicine Unit, Lanesborough Wing, St George’s Hospital, Tooting, London SW17 0QT, United Kingdom
Author contributions: All authors contributed equally to the preparation of this manuscript; The preparation of the manuscript, tables and figures was done by Vinayagam D and Leslie K; Khalil A provided further input and guidance to the preparation of the manuscript; Thilaganathan B designed the outline of the manuscript and coordinated the writing and revision of the manuscript prior to final submission.
Conflict-of-interest statement: The authors report no conflict of interest with regards to the contents of this minireview.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Baskaran Thilaganathan, MD, PhD, FRCOG, Professor of Fetal Medicine, Fetal Maternal Medicine Unit, Lanesborough Wing, St George’s Hospital, Tooting, London SW17 0QT, United Kingdom. basky@pobox.com
Telephone: +44-20-87250071 Fax: +44-20-87250079
Received: May 29, 2015
Peer-review started: June 3, 2015
First decision: August 4, 2015
Revised: September 3, 2015
Accepted: October 1, 2015
Article in press: October 8, 2015
Published online: November 10, 2015
Processing time: 164 Days and 23 Hours
Core Tip

Core tip: The conventional paradigm is that preeclampsia (PE) is solely due to placental dysfunction. However not all cases of placental dysfunction result in the syndrome of PE. Equally, placental dysfunction - as evidenced by impaired uterine artery Doppler indices, low birth weight and abnormal histology - is not always present in PE. Therefore, the heterogeneity observed in PE cannot be solely explained by placental dysfunction. There is now strong evidence supporting the role of the maternal cardiovascular system in PE. In this mini-review, we evaluate the evidence supporting a dual aetiology of PE, involving both the placenta and the maternal cardiovascular system.