SERUM CONCENTRATIONS OF CA-125 IN NORMAL AND PREECLAMPTIC PREGNANCIES

Abstract

Preeclampsia is a common disease in Egypt and the whole world. It is one of the important causes of maternal and neonatal morbidity and mortality. The disease manifestations include hypertension, edema, proteinuria, impaired liver and renal functions and also visual disturbances. The incidence of preeclampsia is 2-8% and reaches 3-10% in primigravida. The incidence is markedly influenced by race, ethnicity, environmental and socioeconomic factors. The incidence in developed countries as United States is 5-8% while in developing countries; it ranges from 4% to reach 18% in some parts of Africa. Many risk factors have been implicated which include: advanced maternal age (more than 35 years), nulliparity, long inter-birth interval (≥ 5 years), previous personal or family history of preeclampsia, multiple pregnancy, obesity and preexisting medical conditions (e.g. chronic hypertension, chronic renal disease, etc.). Many theories have attempted to explain the mechanism of preeclampsia, but its exact pathogenesis remains unclear. The current theory that attempts to explain the mechanism of preeclampsia is the abnormal implantation which leads to placental hypoxia that causes release of inflammatory mediators which act on the vascular endothelium causing altered vascular reactivity and decreased intravascular volume. Another theory is abnormal maternal adaptation towards pregnancy. This abnormal immunological tolerance may provoke an immune response against the placenta and even paternal antigens of the fetus. Therefore, cytotrophoblastic invasion becomes defective and suppressed. The genetic theory is also possible due to increased incidence of preeclampsia in women with family history of the disease but still there is the need for more research to isolate the implicated genes.