Pathophysiology
PIH and especially PE is considered to be a multifactorial
disease. Many theories have been developed
about its pathogenesis. Their common characteristic is
the central role of the placenta. The modified theory
of the “two-stage model” suggests that abnormal placental implantation, vascularization or function
together with the contribution of maternal factors
can lead to PE.53 Factors that have been implicated
in PE pathophysiology are cardiovascular maladaptation
and vasoconstriction, genetic predisposition,
immunologic intolerance between feto-placental and
maternal tissue, platelet activation and vascular endothelial
dysfunction.54 Moreover, coexisting metabolic
factors can contribute to endothelial dysfunction, and
hyperlipidaemia and insulin resistance have been
associated with preeclampsia.