Preeclampsia (PE) is a form of gestational hypertension that complicates ∼5% of pregnancies worldwide. Over 70% of the fatal cases of PE are attributed to cerebral oedema, intracranial haemorrhage and eclampsia. The aetiology of PE originates from abnormal remodelling of the maternal spiral arteries, creating an ischaemic placenta that releases factors that drive the pathophysiology. An initial neurological outcome of PE is the absence of the autonomically regulated cardiovascular adaptations to pregnancy. PE patients exhibit sympathetic overactivation, in comparison with both normotensive pregnant and hypertensive non-pregnant females. Moreover, PE diminishes baroreceptor reflex sensitivity (BRS) beyond that observed in healthy pregnancy. The absence of the cardiovascular adaptations to pregnancy, combined with sympathovagal imbalance and a blunted BRS leads to life-threatening neurological outcomes. Behaviourally, the increased incidences of maternal depression, anxiety and post-traumatic stress disorder (PTSD) in PE are correlated to low fetal birth weight, intrauterine growth restriction (IUGR) and premature birth. This review addresses these neurological consequences of PE that present in the gravid female both during and after the index pregnancy.
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August 2016
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GABAB receptor-mediated hypertension via hyperpolarization of solitary tract nucleus neurons that receive and integrate baroreceptor afferent inputs. See pp. 1417-1434 for further details. Image kindly provided by Omar Logue
Review Article|
July 07 2016
Preeclampsia and the brain: neural control of cardiovascular changes during pregnancy and neurological outcomes of preeclampsia
Omar C. Logue;
*Department of Neurology, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A.
Correspondence: Omar C. Logue (email [email protected]).
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Eric M. George;
Eric M. George
†Department of Physiology, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A.
‡Department of Biochemistry, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A.
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Gene L. Bidwell, III
Gene L. Bidwell, III
*Department of Neurology, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A.
‡Department of Biochemistry, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A.
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Publisher: Portland Press Ltd
Received:
February 15 2016
Revision Received:
April 27 2016
Accepted:
May 13 2016
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2016 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society
2016
Clin Sci (Lond) (2016) 130 (16): 1417–1434.
Article history
Received:
February 15 2016
Revision Received:
April 27 2016
Accepted:
May 13 2016
Citation
Omar C. Logue, Eric M. George, Gene L. Bidwell; Preeclampsia and the brain: neural control of cardiovascular changes during pregnancy and neurological outcomes of preeclampsia. Clin Sci (Lond) 1 August 2016; 130 (16): 1417–1434. doi: https://doi.org/10.1042/CS20160108
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