*Review* **Preeclampsia: The Relationship between Uterine Artery Blood Flow and Trophoblast Function**

**Anna Ridder 1,**†**, Veronica Giorgione 1,**†**, Asma Khalil 1,2 and Basky Thilaganathan 1,2,\***


Received: 15 May 2019; Accepted: 28 June 2019; Published: 2 July 2019

**Abstract:** Maternal uterine artery blood flow is critical to maintaining the intrauterine environment, permitting normal placental function, and supporting fetal growth. It has long been believed that inadequate transformation of the maternal uterine vasculature is a consequence of primary defective trophoblast invasion and leads to the development of preeclampsia. That early pregnancy maternal uterine artery perfusion is strongly associated with placental cellular function and behaviour has always been interpreted in this context. Consistently observed changes in pre-conceptual maternal and uterine artery blood flow, abdominal pregnancy implantation, and late pregnancy have been challenging this concept, and sugges<sup>t</sup> that abnormal placental perfusion may result in trophoblast impairment, rather than the other way round. This review focuses on evidence that maternal cardiovascular function plays a significant role in the pathophysiology of preeclampsia.

**Keywords:** preeclampsia; uterine artery; maternal cardiovascular system
