The ISSHP European Congress successfully concluded in Berlin last week. The event was a huge success with four days of world-class research along with an active social programme.

The meeting was opened by ISSHP president Dr Mark Brown who reflected on four years at the helm of ISSHP in which the society moved from strength to strength reflected by an increased membership of ISSHP, regular society newsletters along with an interactive and dynamic website. The highlight is undoubtedly Pregnancy Hypertension, now being one of the leading Obstetric journals.

The event was a huge success with four days of world-class research along with an active social programme. The meeting was opened by ISSHP president Dr Mark Brown who reflected on four years at the helm of ISSHP in which the society moved from strength to strength reflected by an increased membership of ISSHP, regular society newsletters along with an interactive and dynamic website. The highlight is undoubtedly Pregnancy Hypertension, now being one of the leading Obstetric journals.

Dr Brown had at the start of his stewardship laid out seven ways to make a difference. In his President’s address, he reviewed these and highlighted progress. Key markers of progress included;

• ISSHP classification & definitions
• Guidelines for Diagnosis, Prevention, Prediction, & Management 2017
• The Integration of basic science and clinical practice in all our meetings which was obvious at Budapest, Sao Paulo and Berlin.
• Improved links with SGI, WHO, FIGO and others
• The establishment of a subcommittee with a focus on LMIC lead by Professor Peter von Dadelszen
• Joint research awards with Pre-eclampsia foundation and Pre-empt ($30,000 USD)
• The support of Young Investigators via Travel grants; registration fees; Society fees
• Inaugural World Pre-eclampsia day which was held on May 22^nd, 2017 and included events held in USA, Australia, Ireland, UK and others

Challenges for our new President, Professor Laura Magee include building on this excellent momentum, further increasing membership and establishing ISSHP as the “go- to” brand for pregnancy hypertension globally.

Professor Louise Kenny presented the Secretary/ Treasurers report which included numerous positive updates. These included upgrading of the ISSHP website in 2017, intended to better detail the work of ISSHP, build a network for researchers and facilitate easier and faster payment of membership subscriptions. Efforts continue to be made to encourage payment of membership subscriptions. Regular newsletters are issued with support and input from members. Professor Kenny reported that member subscriptions continue to be challenging in 2017 and all members are to be encouraged to pay their subscriptions and recruit another member to the society.  Benefits of membership include access to the Pregnancy Hypertension Journal, the support of researchers in LMIC Countries, reduced conference fees, and access to exclusive research-related content on the ISSHP website.

The European Congress also had an excellent mix of science and clinical research. The conference got off to a great start with a three-way debate on the aetiology underlying pre-eclampsia. Intriguing arguments presented by Professor Thilaganathan supporting the fact that the placenta is dependent on adequate perfusion by the maternal circulation and pre-eclampsia occurs as a result of maternal cardiovascular maladaptation to pregnancy. This was counter-argued by Professor Chris Redmond who provided convincing evidence regarding the placental aetiology of pre-eclampsia. Finally, Professor Karumanchi argued that in fact, pre-eclampsia is an angiogenic factor-mediated disorder.

Other research highlights included Professor Graham Burton’s description of the unfolded protein response pathway activation in pre-eclampsia resulting in a reduction of placental cell proliferation resulting in increased oxidative stress and remodelling of the placental vasculature. In addition to discussions on underlying aetiology, Professor Thadhani presented data on targeted therapies in pre-eclampsia. Their research team conducted two single-arm proof of concept clinical studies to determine the feasibility apheresis using dextran-sulphate adsorption columns with the aim of removing sFlt-1 from the maternal blood of women with pre-term pre-eclampsia. Dr Winkler followed this talk with their use of heparin-mediated extracorporeal LDL- precipitation apheresis for the removal of lipoprotein to alleviate pre-eclampsia. Dr David Williams presented the results of the STAMP trial (statins to ameliorate pre-eclampsia). These overall negative results contrasted with the hugely positive results presented by Professor Girardi which highlighted their use of statins in women with APS. Angiogenic factors featured prominently with many researchers, in particular, investigating the use of PlGF in the prediction of disease and need for delivery.  Dr McCarthy presented their results highlighting similar results in the prediction of the need for delivery secondary to preterm pre-eclampsia regardless of whether one uses the DELFIA Xpress PlGF 1-2-3 test, Triage PlGF or Elecsys immunoassay sFlt-1/PlGF.

Dr Andrew Sharp presented results from the MAPPLE study, comparing results from the PELCIAN study (concealed PlGF) and MAPPLE (revealed PlGF) study. Revealed PlGF had fewer perinatal deaths but higher perinatal adverse outcomes mainly due to increased respiratory morbidity. Long-term maternal health following hypertensive disorders of pregnancy were well represented at the meeting. Dr Ali Khashan presented his work from the Swedish Medical Birth registry demonstrating that women with pre-eclampsia are 2-3 fold increased risk of ESRD and 40% increased risk of CKD compared to parous women with no pre-eclampsia. These findings were echoed by Dr Kristensen using the Danish health Registry. Ms Gillian Maher highlighted associations between hypertensive disorders of pregnancy and a modest increase in the risk of ADHD and Autism spectrum disorder in the offspring of women with pre-eclampsia.

Finally, how common is pre-eclampsia in the UK? What seems like such a simple question but data on the incidence of pre-eclampsia is lacking. Professor Lucy Chappell and team presented an audit of 16 sites participating in the PHOENIX study, The overall incidence was found to be 1.92%.

Overall this was a meeting packed with exciting science highlighting incredible commitment to improving pregnancy outcomes in women with hypertensive disorders of pregnancy.