子痫前期是妊娠期特有的多系统进展性疾病，是导致母儿发病及死亡的主要原因之一。而胎盘作为子痫前期发病的核心"始动器官"，其病理改变贯穿疾病全程，不仅是疾病发生发展的病理基础，更与临床诊疗决策、病情评估及预后判断密切相关。本文结合阿姆斯特丹胎盘共识整合最新研究成果，系统阐述子痫前期胎盘的大体病理及镜下病理特征，分析胎盘的病理改变与临床症状、病情严重程度及母儿预后的关联，为子痫前期的早期预警、精准诊断、个体化治疗及预后评估提供病理支撑。

Preeclampsia is a multisystem progressive disease unique to pregnancy and one of the leading causes of maternal and fetal morbidity and mortality. As the core initiating organ in the pathogenesis of preeclampsia, the placenta undergoes pathological changes throughout the entire course of the disease. These changes not only serve as the pathological basis for the occurrence and progression of preeclampsia but also are closely associated with clinical diagnosis and treatment decision-making, disease severity evaluation, and prognostic judgment. Based on the Amsterdam Placental Consensus and the latest research advances, this manuscript systematically elaborates the gross and microscopic pathological features of the placenta in preeclampsia, and further analyzes the correlations between placental pathological alterations and clinical symptoms, disease severity, as well as maternal and fetal prognosis, to provide pathological evidence for the early warning, precise diagnosis, individualized treatment and prognostic assessment of preeclampsia.