Which condition is associated with endothelial dysfunction during pregnancy?

The condition associated with endothelial dysfunction during pregnancy is preeclampsia. This disorder is characterized by the development of hypertension and proteinuria after the 20th week of gestation. The pathophysiology of preeclampsia is largely linked to abnormal placentation and the resulting endothelial dysfunction. In preeclampsia, inadequate remodeling of the maternal spiral arteries leads to decreased uteroplacental perfusion, which causes a release of factors into the maternal circulation that further exacerbate endothelial injury. This endothelial dysfunction contributes to systemic vasoconstriction, increased vascular permeability, and inflammatory responses, all of which are hallmarks of the condition.

While HELLP syndrome, a complication of preeclampsia, involves liver dysfunction and hemolysis, it is ultimately considered a severe manifestation of the underlying endothelial dysfunction initiated by preeclampsia. Eclampsia occurs as a progression of preeclampsia when seizures develop, and while it is severe, it does not solely emphasize the endothelial dysfunction aspect. Gestational diabetes is related to insulin resistance during pregnancy and does not involve the same endothelial pathology as preeclampsia. Thus, preeclampsia is the most direct condition linked to endothelial dysfunction during pregnancy