Therapeutic strategies for the prevention and treatment of pre-eclampsia and intrauterine growth restriction

Intrauterine growth restriction and pre-eclampsia are common pregnancy complications that contribute significantly to maternal and perinatal morbidity and mortality, and long term health outcomes. The underlying aetiology of these conditions involves placental underperfusion and placental ischaemia. Most prophylactic and treatment measures for these conditions are hypothesized to have effect through improved placental perfusion, or reduced oxidative stress and subsequent placental damage. However, while many therapies have biologic plausibility, there is a lack of high quality evidence that they substantially improve important outcomes such as birth weight, prematurity, mortality or serious morbidity. This review will describe and evaluate therapies currently available in clinical practice for the prevention and treatment of pre-eclampsia and intrauterine growth restriction, and outline some promising new therapies, which may change the way these conditions are managed in the future.