Dr Roger McMaster-Fay

Gynaecologist and Endoscopic Surgeon - Clinical Lecturer, Sydney University

An explanation of Pre-Eclampsia

Pre-Eclampsia is one of the most serious diseases that can complicate a pregnancy, putting at risk the lives of both the infant and the mother. The reasons why and how this condition occurs still remains essentially a mystery. Pre-Eclampsia is the development of high blood pressure along with protein in the urine (proteinuria), excessive fluid retention (oedema) and a rise in the uric acid level in the blood (hyperuricaemia). Once this condition develops it is necessary to deliver the infant, otherwise disastrous consequences can and will ensue. If we knew how this disease develops (its pathogenesis) then we may be able to intervene before the disease fully develops and improve the outcomes for both mother and infant. It has been estimated that 50,000 maternal deaths occur worldwide each year as a result of this disease!

I have been conducting research into Pre-Eclampsia since 1980. Listed below are sixteen research papers that have been published on the subject. The first of these, my ‘opus’, is a hypothesis on the pathogenesis of the disease. It was published in 2008.


McMaster-Fay RA. Pre-eclampsia: a disease of oxidative stress resulting from the catabolism of DNA (primarily fetal) to uric acid by xanthine oxidase in the maternal liver; a hypothesis.
Bioscience Hypotheses 2008; 1: 35-43.
Find it here

Additional articles on Pre-Eclampsia by Roger A. McMaster-Fay (FAY)

Fay RA, Hughes AO, Farron NT.
Platelets in pregnancy : hyperdestruction in pregnancy.
Obstet Gynecol 1983; 61: 238 240.

Fay RA, Bromham DR, Brooks JA, Gebski VJ.
Platelets and uric acid in the prediction of pre eclampsia.
Am J Obstet Gynecol 1985; 152: 1038 1039

Fay RA.
Pregnancy induced hypertension and renal failure: clinical importance of diuretics, plasma volume and vasospasm.
Aust N Z J Obstet Gynaecol 1990; 30: 88.

Fay RA.
Uric acid in pregnancy and pre-eclampsia: an alternative hypothesis.
Aust N Z J Obstet Gynaecol 1990; 30: 141-142.

Fay RA.
Serum uric acid in normal pregnancy.
Aust N Z J Obstet Gynaecol 1991; 31: 91-2.

Fay RA, Ellwood DA.
Doppler investigation of uteroplacental blood flow resistance in the second trimester: a screening study for pre-eclampsia and intrauterine growth retardation.
BJOG 1992; 99: 527-8.

CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women.
Lancet 1994; 343: 619-629.

Fay RA, Ellwood DA, Bruce S, Turner A.
Colour Doppler imaging of the uteroplacental circulation in the middle trimester: observations on the development of a low resistance circulation.
Ultrasound Obstet Gynecol 1994; 4: 391-395.

Fay RA, Ellwood DA, Bruce S, Turner A.
Colour Doppler imaging of the uteroplacental circulation in the mid-trimester: features of the uterine artery flow velocity waveform that predict abnormal pregnancy outcome.
Aust N Z J Obstet Gynaecol 1994; 34: 515-519.

Loupas T, Ellwood DA, Gill RW, Bruce S, Fay RA.
Computer analysis of the early diastolic notch in Doppler sonograms of the uterine arteries.
Ultrasound Med Biol 1995; 21:1001-1011.

Morris JM, Fay RA, Ellwood DA, Cook CM, Devonald KJ.
A randomised controlled trial of aspirin in patients with abnormal uterine artery blood flow.
Obstet Gynecol 1996; 87: 74-78.

Morris J, Fay R, Ellwood D.
Abnormal uterine artery waveforms in the second trimester are associated with adverse pregnancy outcome in high risk women.
J Matern Fetal Invest 1998; 8: 82-84.

McMaster-Fay RA.
Prediction of pre-eclampsia, low birthweight for gestational age and prematurity by uterine artery blood flow velocity waveforms in low risk nulliparous women.
Br J Obstet Gynaecol 1999; 106: 88-9.

McMaster-Fay RA.
Failure of physiologic transformation of the spiral arteries of the uteroplacental circulation in patients with preterm labor and intact membranes.
Am J Obstet Gynecol 2004; 191: 1837-8.

McMaster-Fay RA
Use of Doppler in an Australian level II maternity hospital.
ANZJOG 2006; 46:560.