Keywords
placenta-associated complications
pathogenesis
aspirin
calcium
L-arginine
How to Cite
Abstract
In press
Background. Preeclampsia of varying severity accompanies every tenth pregnancy and is the cause of almost 15% of maternal deaths. Despite the availability of evidence-based recommendations, the issue of optimal selection and combination of preventive strategies remains the subject of active scientific discussions, which determines the expediency of generalizing current data in the context of the pathogenesis of preeclampsia.
Aim. To systematize and critically analyze current scientific literature on the pathogenetic mechanisms of preeclampsia development and the evidence base for the use of pharmacological and nutritional approaches for its prevention.
Materials and Methods. The study was conducted using systematic analysis and bibliosemantic method, within the framework of the study with the state registration number 0124U001136. The search for sources was performed in PubMed and Google Scholar databases for the period 1985–2025.
Research Ethics. The review was conducted in accordance with the ethical principles of scientific research. Only publicly available and published scientific literature data were used, without involving patients, biological samples, or any personalized information.
Results. The analysis of literary sources demonstrates that preeclampsia is a multifactorial placenta-mediated syndrome, for which there is currently no universal preventive approach. The most convincing evidence base comes from studies on the use of acetylsalicylic acid. The effectiveness of using this drug depends on the dose and early initiation of application. Calcium supplementation reliably reduces the risk of preeclampsia, especially in women with low baseline calcium consumption. L-arginine demonstrated pathogenic rationale and the ability to reduce the frequency of preeclampsia and its severe forms in high-risk groups. Data on metformin, statins, and low-molecular-weight heparin are promising but remain heterogeneous. The effects of their application require further study, particularly from the standpoint of safety for pregnant women and the fetus. Vitamin monotherapy and dietary interventions do not have convincing evidence of effectiveness, while combined approaches demonstrate more encouraging results.
Conclusions. The conducted literature review indicates that, despite progress in understanding the pathogenesis of preeclampsia, a universally effective strategy for its prevention currently does not exist. The heterogeneity of clinical forms and disease development mechanisms determines the limited efficacy of monotherapy and necessitates an individualized approach. Modern preventive strategies are oriented toward key pathogenetic pathways, which explains the growing interest in combined and targeted interventions.
Keywords: obstetrics, placenta-associated complications, pathogenesis, aspirin, calcium, L-arginine.
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