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Preeclampsia is an inflammatory condition, involving the pregnant mother and complicated by the presence of a growing child and a disfunctional placenta; such is its complexity that so far no one has been able to fully elucidate its pathophysiology. Varicose veins are an inflammatory condition also, but far simpler and localised, whose pathophysiology has recently been virtually fully established by a combination of clinical observation, animal experiment and analysis of stripped veins. They have indicated the immediate cause of inflammation is stimulation of a tissue by increased levels of plasma noradrenaline, at basal concentration, diffusing into it from its microcirculation. The hypothesis offered here applies that information and proposes the changes in the uteroplacental tissues in preeclampsia are a result of a decreased level of microcirculatory noradrenaline stimulation, and the changes in the maternal tissues are a result of an increased level. The dichotomy means any treatment likely to benefit the mother in preeclampsia is likely to harm the child and vice versa. That may explain why the spectacular therapeutic advances of the past 50-60 years have had, relatively, so little impact on the treatment of preeclampsia. However, experiments aimed at finding tissue specific drugs to treat different aspects of HIV and individual types of cancer offer some slight hope that in the long term it may be possible to at least alleviate preeclampsia, if not cure it. Copyright © 2012 Elsevier Ltd. All rights reserved.


T P Crotty. Imbalances in the neurotrophic effects of noradrenaline, favouring the positive in the child and the negative in the mother, are the cause of preeclampsia. Medical hypotheses. 2012 Nov;79(5):572-81

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PMID: 22922053

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