The pathogenesis of pre-eclampsia: new aspects.

The etiology of pre-eclampsia, a disorder specific to pregnancy, has not yet been clearly established. Generalized endothelial dysfunction is thought to occur. Inadequate trophoblast invasion at the feto-maternal junction has also been postulated as the cause. However, recent findings are more suggestive of an inappropriate maternal inflammatory response within the framework of placentation, the innate immune system being primarily involved. This exaggerated maternal intravascular inflammatory reaction to the invading trophoblast leads to the manifestations of pre-eclampsia in the mother and feto-placental unit. The extent of the inflammatory reaction, which is also present in normal pregnancy, is probably determined by genetic factors and any pre-existing disorder affecting the mother or fetus. The process is very complex and cannot be attributed to any one single cause.