Skip to main content

Part of the book series: Advances in Experimental Medicine and Biology ((AIM,volume 956))

Abstract

Superimposed preeclampsia refers to women with chronic arterial hypertension (primary or secondary) who develop preeclampsia (PE). Because hypertension affects 5–15 % of pregnancies, it is itself a matter of concern. However, this concern should be permanent, given the increased risk of the hypertension worsening and, particularly, the appearance of superimposed PE. The search for factors that underlie or promote the development of this disorder has been the subject of intense research. However, despite the wealth of knowledge, the cause or causes remain to be determined.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

ACOG:

American College of Obstetricians and Gynecologists

eNOS:

endothelial nitric oxide synthase

IUGR:

intra-uterine growth restriction

LR:

likelihood ratio

NO:

nitric oxide

PE:

preeclampsia

PI:

pulsatility index

PlGF:

placental growth factor

sFlt-1:

soluble fms-like tyrosine kinase

sPE:

superimposed preeclampsia

UtA:

uterine artery

−ve:

negative

+ve:

positive

VEGF:

vascular endothelial growth factor.

References

  • Aardema MW, Saro MC, Lander M, De Wolf BT, Oosterhof H, Aarnoudse JG (2004) Second trimester Doppler ultrasound screening of the uterine arteries differentiates between subsequent normal and poor outcomes of hypertensive pregnancy: two different pathophysiological entities? Clin Sci (Lond) 106(4):377–382

    Article  CAS  Google Scholar 

  • American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy (2013) Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol 122(5):1122–1131

    Google Scholar 

  • Amorim MM, Santos LC, Faúndes A (1999) Corticosteroid therapy for prevention of respiratory distress syndrome in severe preeclampsia. Am J Obstet Gynecol 180(5):1283–1288

    Article  CAS  PubMed  Google Scholar 

  • Anumba DO, Lincoln K, Robson SC (2010) Predictive value of clinical and laboratory indices at first assessment in women referred with suspected gestational hypertension. Hypertens Pregnancy 29(2):163–179

    Article  CAS  PubMed  Google Scholar 

  • Balasch J, Gratacós E (2011) Delayed childbearing: effects on fertility and the outcome of pregnancy. Fetal Diagn Ther 29(4):263–273

    Article  PubMed  Google Scholar 

  • Bramham K, Parnell B, Nelson-Piercy C, Seed PT, Poston L, Chappell LC (2014) Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis. BMJ 348:g2301

    Article  PubMed  PubMed Central  Google Scholar 

  • Brosens I, Pijnenborg R, Vercruysse L, Romero R (2011) The “Great Obstetrical Syndromes” are associated with disorders of deep placentation. Am J Obstet Gynecol 204(3):193–201

    Article  PubMed  Google Scholar 

  • Chappell LC, Enye S, Seed P, Briley AL, Poston L, Shennan AH (2008) Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension: a prospective study. Hypertension 51(4):1002–1009. doi:10.1161/HYPERTENSIONAHA.107.107565

    Article  CAS  PubMed  Google Scholar 

  • Cnossen JS, Morris RK, ter Riet G, Mol BW, van der Post JA, Coomarasamy A, Zwinderman AH, Robson SC, Bindels PJ, Kleijnen J, Khan KS (2008) Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ 178(6):701–711

    Article  PubMed  PubMed Central  Google Scholar 

  • de Mouzon J, Goossens V, Bhattacharya S, Castilla JA, Ferraretti AP, Korsak V, Kupka M, Nygren KG, Nyboe Andersen A, European IVF-monitoring (EIM) Consortium, for the European Society of Human Reproduction and Embryology (ESHRE) (2010) Assisted reproductive technology in Europe, 2006: results generated from European registers by ESHRE. Hum Reprod 25(8):1851–1862

    Article  PubMed  Google Scholar 

  • Edwards EW, DiPette DJ, Townsend RR, Cohen DL (2014) Top 10 landmark studies in hypertension. J Am Soc Hypertens 8(6):437–447

    Article  PubMed  Google Scholar 

  • Ferrer RL, Sibai BM, Mulrow CD, Chiquette E, Stevens KR, Cornell J (2000) Management of mild chronic hypertension during pregnancy: a review. Obstet Gynecol 96(5 Pt 2):849–860

    CAS  PubMed  Google Scholar 

  • Frusca T, Soregaroli M, Platto C, Enterri L, Lojacono A, Valcamonico A (2003) Uterine artery velocimetry in patients with gestational hypertension. Obstet Gynecol 102(1):136–140

    CAS  PubMed  Google Scholar 

  • Gómez O, Figueras F, Fernández S, Bennasar M, Martínez JM, Puerto B, Gratacós E (2008) Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation. Ultrasound Obstet Gynecol 32(2):128–132

    Article  PubMed  Google Scholar 

  • Grummer MA, Sullivan JA, Magness RR, Bird IM (2009) Vascular endothelial growth factor acts through novel, pregnancy-enhanced receptor signalling pathways to stimulate endothelial nitric oxide synthase activity in uterine artery endothelial cells. Biochem J 417(2):501–511

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Guedes-Martins L, Saraiva J, Gaio R, Macedo F, Almeida H (2014a) Uterine artery impedance at very early clinical pregnancy. Prenat Diagn 34(8):719–725

    Article  PubMed  Google Scholar 

  • Guedes-Martins L, Cunha A, Saraiva J, Gaio R, Macedo F, Almeida H (2014b) Internal iliac and uterine arteries Doppler ultrasound in the assessment of normotensive and chronic hypertensive pregnant women. Sci Rep 4:3785

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Guedes-Martins L, Gaio R, Saraiva J, Cerdeira S, Matos L, Silva E, Macedo F, Almeida H (2015) Reference ranges for uterine artery pulsatility index during the menstrual cycle: a cross-sectional study. PLoS One 10(3), e0119103

    Article  PubMed  PubMed Central  Google Scholar 

  • Hajjar I, Kotchen JM, Kotchen TA (2006) Hypertension: trends in prevalence, incidence, and control. Annu Rev Public Health 27:465–490

    Article  PubMed  Google Scholar 

  • Istance D, Theisens H (2008) Ageing OECD societies in trends shaping education 2008. Centre for Educational Research and Innovation. Organization for Economic Co-Operation and Development, OECD, pp 13–20

    Google Scholar 

  • Jacobsson B, Ladfors L, Milsom I (2004) Advanced maternal age and adverse perinatal outcome. Obstet Gynecol 104(4):727–733

    Article  PubMed  Google Scholar 

  • Karumanchi SA, Maynard SE, Stillman IE, Epstein FH, Sukhatme VP (2005) Preeclampsia: a renal perspective. Kidney Int 67(6):2101–2113

    Article  PubMed  Google Scholar 

  • Konje JC, Kaufmann P, Bell SC, Taylor DJ (2001) A longitudinal study of quantitative uterine blood flow with the use of color power angiography in appropriate for gestational age pregnancies. Am J Obstet Gynecol 185(3):608–613

    Article  CAS  PubMed  Google Scholar 

  • Lain KY, Roberts JM (2002) Contemporary concepts of the pathogenesis and management of preeclampsia. JAMA 287(24):3183–3186

    Article  PubMed  Google Scholar 

  • Leow MK (2015) Environmental origins of hypertension: phylogeny, ontogeny and epigenetics. Hypertens Res 38:299

    Article  PubMed  Google Scholar 

  • Li H, Gudnason H, Olofsson P, Dubiel M, Gudmundsson S (2005) Increased uterine artery vascular impedance is related to adverse outcome of pregnancy but is present in only one-third of late third-trimester preeclamptic women. Ultrasound Obstet Gynecol 25(5):459–463

    Article  CAS  PubMed  Google Scholar 

  • Mandala M, Osol G (2012) Physiological remodelling of the maternal uterine circulation during pregnancy. Basic Clin Pharmacol Toxicol 110(1):12–18

    Article  CAS  PubMed  Google Scholar 

  • Mathews TJ, Hamilton BE (2009) Delayed childbearing: more women are having their first child later in life. NCHS data brief, no 21. Hyattsville, MD. National Center for Health Statistics 21:1–8

    Google Scholar 

  • Meler E, Figueras F, Mula R, Crispi F, Benassar M, Gómez O, Gratacós E (2010) Prognostic role of uterine artery Doppler in patients with preeclampsia. Fetal Diagn Ther 27(1):8–13

    Article  PubMed  Google Scholar 

  • Menken J, Trussell J, Larsen U (1986) Age and infertility. Science 233(4771):1389–1394

    Article  CAS  PubMed  Google Scholar 

  • National Institutes of Health Consensus Development Panel (2001) Antenatal corticosteroids revisited: repeat courses – National Institutes of Health Consensus Development Conference Statement, August 17–18, 2000. Obstet Gynecol 98(1):144–150

    Article  Google Scholar 

  • National Heart, Lung and Blood Institute (2001) Report of the working group on research on hypertension during pregnancy. http://www.nhlbi.nih.gov/resources/hyperten_preg/

  • Osol G, Mandala M (2009) Maternal uterine vascular remodeling during pregnancy. Physiology (Bethesda, Md) 24:58–71

    Article  Google Scholar 

  • Oyelese Y, Ananth CV (2006) Placental abruption. Obstet Gynecol 108(4):1005–1016

    Article  PubMed  Google Scholar 

  • Palmer RM, Ashton DS, Moncada S (1988) Vascular endothelial cells synthesize nitric oxide from L-arginine. Nature 333(6174):664–666

    Article  CAS  PubMed  Google Scholar 

  • Papageorghiou AT, Yu CK, Bindra R, Pandis G, Nicolaides KH, Fetal Medicine Foundation Second Trimester Screening Group (2001) Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation. Ultrasound Obstet Gynecol 18(5):441–449

    Article  CAS  PubMed  Google Scholar 

  • Papageorghiou AT, Yu CK, Erasmus IE, Cuckle HS, Nicolaides KH (2005) Assessment of risk for the development of pre-eclampsia by maternal characteristics and uterine artery Doppler. BJOG 112(6):703–709

    Article  PubMed  Google Scholar 

  • Ray JG, Burrows RF, Burrows EA, Vermeulen MJ (2001) MOS HIP: McMaster outcome study of hypertension in pregnancy. Early Hum Dev 64(2):129–143

    Article  CAS  PubMed  Google Scholar 

  • Rosenfeld CR, DeSpain K, Word RA, Liu XT (2012) Differential sensitivity to angiotensin II and norepinephrine in human uterine arteries. J Clin Endocrinol Metab 97(1):138–147

    Article  CAS  PubMed  Google Scholar 

  • Samuel A, Lin C, Parviainen K, Jeyabalan A (2011) Expectant management of preeclampsia superimposed on chronic hypertension. J Matern Fetal Neonatal Med 24(7):907–911. doi:10.3109/14767058.2010.535874

    Article  PubMed  Google Scholar 

  • Seely EW, Ecker J (2014) Chronic hypertension in pregnancy. Circulation 129(11):1254–1261

    Article  PubMed  Google Scholar 

  • Seely EW, Solomon CG (2016) Improving the prediction of preeclampsia. N Engl J Med 374(1):83–84. doi:10.1056/NEJMe1515223

    Article  CAS  PubMed  Google Scholar 

  • Sibai BM, Stella CL (2009) Diagnosis and management of atypical preeclampsia-eclampsia. Am J Obstet Gynecol 200(5):481.e1-7

    Article  PubMed  Google Scholar 

  • Sibai B, Dekker G, Kupferminc M (2005) Pre-eclampsia. Lancet 365(9461):785–799

    Article  PubMed  Google Scholar 

  • Smith GC, Yu CK, Papageorghiou AT, Cacho AM, Nicolaides KH, Fetal Medicine Foundation Second Trimester Screening Group (2007) Maternal uterine artery Doppler flow velocimetry and the risk of stillbirth. Obstet Gynecol 109(1):144–151

    Article  PubMed  Google Scholar 

  • Sprague BJ, Phernetton TM, Magness RR, Chesler NC (2009) The effects of the ovarian cycle and pregnancy on uterine vascular impedance and uterine artery mechanics. Eur J Obstet Gynecol Reprod Biol 144(Suppl 1):S170–S178

    Article  PubMed  PubMed Central  Google Scholar 

  • Steer CV, Williams J, Zaidi J, Campbell S, Tan SL (1995) Intra-observer, interobserver, interultrasound transducer and intercycle variation in colour Doppler assessment of uterine artery impedance. Hum Reprod 10(2):479–481

    Article  CAS  PubMed  Google Scholar 

  • van den Elzen HJ, Cohen-Overbeek TE, Grobbee DE, Quartero RW, Wladimiroff JW (1995) Early uterine artery Doppler velocimetry and the outcome of pregnancy in women aged 35 years and older. Ultrasound Obstet Gynecol 5(5):328–333

    Article  PubMed  Google Scholar 

  • van Katwijk C, Peeters LL (1998) Clinical aspects of pregnancy after the age of 35 years: a review of the literature. Hum Reprod Update 4(2):185–194

    Article  PubMed  Google Scholar 

  • Vodstrcil LA, Tare M, Novak J, Dragomir N, Ramirez RJ, Wlodek ME, Conrad KP, Parry LJ (2012) Relaxin mediates uterine artery compliance during pregnancy and increases uterine blood flow. FASEB J 26(10):4035–4044

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Competing Financial Interests

The author declares no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Luís Guedes-Martins .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing AG

About this chapter

Cite this chapter

Guedes-Martins, L. (2016). Superimposed Preeclampsia. In: Islam, M.S. (eds) Hypertension: from basic research to clinical practice. Advances in Experimental Medicine and Biology(), vol 956. Springer, Cham. https://doi.org/10.1007/5584_2016_82

Download citation

  • DOI: https://doi.org/10.1007/5584_2016_82

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44250-1

  • Online ISBN: 978-3-319-44251-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics