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

Fetal 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 is placental under-perfusion and ischemia. Most prophylactic and treatment measures for these conditions are hypothesized to have effect through improved placental perfusion, or reduced oxidative stress, inflammation 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 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.