ABSTRACT
The placenta ............................................................................................... 120
Pre-eclampsia ........................................................................................... 121
Fetal growth restriction ....................................................................... 125
Defi nition and incidence ..................................................................... 126
Placental abruption ................................................................................ 128
Additional reading ................................................................................... 131
Pre-eclampsia is a leading cause of maternal death. The World Health Organization estimates that globally between 50 000
and 75 000 women die of this condition each year. Furthermore, pre-eclampsia is frequently accompanied by fetal growth
restriction (FGR), which is responsible for considerable perinatal morbidity and mortality. Although fetal growth is controlled
by a number of factors including genetic predisposition and maternal nutritional status, it is now apparent that the origins
of both pre-eclampsia and much of FGR seen in clinical practice lie in defective placentation. A further condition frequently
related to impaired placentation is abruptio placentae or placental abruption. This is the premature separation of a normally
sited placenta, which is usually of sudden onset and associated with a high fetal mortality and substantial maternal morbidity
and mortality. Knowledge of the early events in the invasion of the maternal uterine wall by placental trophoblast cells is
therefore helpful in understanding the aetiology of these important clinical conditions.
