Comparative characteristics of experimental models of the cerebral complications development in preeclampsia (literature review)

Preeclampsia is a multisystem complication of pregnancy and is one of the leading causes of maternal morbidity and mortality worldwide. Cerebral complications, including Posterior reversible encephalopathy syndrome (PRES), eclampsia and stroke, are life-threatening conditions for the mother that require in-depth study. While diagnostic criteria for preeclampsia appear after 20 weeks of pregnancy, the initial pathogenetic mechanisms are formed much earlier. Clinical studies have obvious limitations in determining the role of trigger factors in the development and progression of preeclampsia. The proposed preclinical animal models make it possible to reproduce individual links in the pathogenesis of preeclampsia, accompanied by the development of characteristic clinical symptoms. The purpose of this review is to analyze publications describing experimental models of the cerebral complications development in preeclampsia. A systematic analysis of modern literature was carried out using the information databases PubMed, Scopus, MEDLINE, Cochrane Library and eLibrary for the period from January 2005 to March 2025. The search strategy included combinations of keywords: “preeclampsia”, “pathogenesis”, “experimental models”, “cerebral edema”, “posterior reversible encephalopathy syndrome”. The initial search gave 1236 results. After removing duplicates and screening according to inclusion criteria (originality, relevance to the topic, accessibility), 50 publications were selected for detailed analysis. This review compares various preclinical models of preeclampsia in terms of their clinical relevance and ability to reproduce PRES. The pathogenetic mechanisms of cerebral disorders in the most widely studied experimental models based on angiogenic imbalance, placental ischemia, and inhibition of endothelial nitric oxide synthase are described. The advantages and disadvantages of each method of modeling hypertensive disorders during pregnancy are presented, taking into account PRES-relevance. PRES models are described separately, including some hypertensive models and combined models. Although preeclampsia is a pathology unique to humans, experimental animal models play a key role in investigating the pathophysiology of this pregnancy complication and remain an important tool for developing new diagnostic and therapeutic methods.

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