An examination on the increased prevalence of preeclampsia in people undergoing assisted reproductive treatments
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Abstract
Preeclampsia (PE), a leading cause of maternal and fetal morbidity and mortality, affects approximately 4-5% of pregnancies and is characterized by the presence of new-onset hypertension, and frequently proteinuria, after 20 weeks gestation. Individuals diagnosed with preeclampsia have been known to suffer from post-pregnancy complications, like cardiovascular disease, and their risk of developing preeclampsia in a subsequent pregnancy also increases. Although the etiology of this disease is not entirely known, research into potential causes have shown that preeclamptic patients have uterine environments that show excessive oxidative stress, inflammation, an imbalance in the levels of factors, proteins, and immune cells necessary for gestation. In much of the research, the maternal immune system and immune response emerges as a principal cause for placental and endothelial dysfunction, both of which can present in preeclampsia. As studies into the etiology of PE advances, the propensity for particular gestations to present with the disease, such as pregnancies conceived via assisted reproductive technologies (ART), is regularly scrutinized by researchers who aim to better understand this pathology. As more individuals look toward reproductive technologies to aid in conception, insight into the possible obstetric complications faced by patients of ART becomes more relevant. An analysis on how and why ART pregnancies have an increased risk of developing this disease further elucidates the effects of an abnormal uterine environment and aberrant maternal immune response on placentation and endothelial remodeling. With ART procedures that utilize frozen embryos or donated gametes showing higher rates of PE–and with the use of these ART protocols rising in popularity worldwide–an awareness and knowledge on the disorders that may afflict ART gestations, especially hypertensive disorders of pregnancy, is necessary for both the advancement of this medical technology and for the general understanding of a pathology as complex as preeclampsia.