Table 2.

Proposed mechanistic pathways involved in preeclampsia.

State of pregnancy	Upstream	Event	Downstream	Clinical symptom/pathology
Rise of vasoinhibin precursors PRL, PL, PGH and vasoinhibin (17, 32, 34, 35, 44)	Upregulation of vasoinhibin-generating enzymes cathepsin-D, MMP-2, MMP-3 (16, 45) by unknown triggers and predisposing factors such as PRL point mutations (46)	Excessive generation of PRL-, PL-, and PGH-derived vasoinhibin isoforms in the placenta (19, 47)	Entering of placental vasoinhibin into the maternal circulation and into amniotic fluid (17–19)	Reduced placental neovascularization, vasopermeability, and vasodilation, high maternal blood pressure, low birth weight (13, 15, 43)