Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Gewählte Publikation:

Holzer, M.
Endothelial Dysfunction in High-Risk Pregnancies: A Systematic Review
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2024. pp.

Autor*innen der Med Uni Graz:
Betreuer*innen:: Cervar-Zivkovic Mila; Kutllovci Hasani Kaltrina
Altmetrics:
Abstract:: Background: High-risk pregnancies continue to be associated with elevated mor-bidity and mortality for both mothers and infants. Current literature establishes a link between endothelial dysfunction and various diseases as well as exogenous factors, that heighten the risk. Notable risk factors include pregnancy induced hy-pertension (PIH), preeclampsia, HELLP-syndrome, gestational diabetes mellitus (GDM), antiphospholipid syndrome (APS), intrauterine growth restriction (IUGR), and infections during pregnancy. Aims and objectives: Due to the correlation of the diseases with endothelial dys-function, this thesis aims to present the pathophysiology associated with the endo-thelium, with the objective to provide a basis for further research on prevention and treatment. Methodology: We conducted a systematic literature review, drawing upon studies identified on PubMed and Web of Science. Results: Cases of PIH, APS, IUGR, and certain exogenous factors exhibit reduced endothelial nitric oxide synthase (eNOS) activity and its product nitric oxide (NO). Conversely, eNOS activity is increased in GDM. Both GDM and preeclampsia are linked to heightened mitogen-activated protein kinase pathway activity, disrupting endothelial function. While obstetric infections, APS, and preeclampsia diminish at least one of the parameters - angiogenesis, proliferation, or migration -, IUGR re-sults in a pathological increase. Conclusion: This review highlights several pathological mechanisms in high-risk pregnancies that could serve as targets for diagnosis and treatment. Acknowledg-ing the limitations of small cohort sizes, further research is imperative.