Neuro-L03-Preeclampsia-Patho & Clinicals

Abnormal placentation in preeclampsia leads to what pathophysiologic process

Incomplete trophoblastic invasion causes poor spiral artery remodeling and placental ischemia.

What does placental ischemia trigger in preeclampsia

Release of antiangiogenic factors like sFlt-1 and endoglin causing endothelial dysfunction.

How does endothelial dysfunction contribute to hypertension in preeclampsia

Decreased nitric oxide and increased vasoconstrictors like endothelin and thromboxane raise systemic vascular resistance.

What renal change occurs due to endothelial injury in preeclampsia

Glomerular endotheliosis leading to proteinuria and reduced GFR.

How does preeclampsia cause edema

Endothelial leakage and loss of oncotic pressure from proteinuria lead to fluid third-spacing.

What is the effect of endothelial dysfunction on the liver

Hepatic sinusoidal obstruction and ischemia elevate AST/ALT and cause right upper quadrant pain.

What neurologic mechanism explains headaches and visual disturbances in preeclampsia

Cerebral vasospasm and vasogenic edema, especially in the occipital lobes.

What causes hyperreflexia and clonus in preeclampsia

Increased CNS irritability due to cerebral edema and impaired autoregulation.

How does eclampsia occur from severe preeclampsia

Diffuse cerebral vasospasm and edema cause cortical irritation and seizures.

What brain area is most affected in eclampsia-related edema

Posterior parietal and occipital lobes, consistent with posterior reversible encephalopathy syndrome (PRES).

How do antiangiogenic factors like sFlt-1 affect VEGF and PlGF

They neutralize VEGF and PlGF, reducing angiogenesis and causing endothelial injury.

What causes the coagulation abnormalities in severe preeclampsia

Endothelial injury activates platelets and microthrombi formation leading to thrombocytopenia and DIC.

What is the ultimate cause of maternal symptoms in preeclampsia

Generalized endothelial dysfunction causing multiorgan hypoperfusion and increased vascular permeability.

What causes renal impairment in preeclampsia

Glomerular endotheliosis reduces GFR leading to oliguria and elevated serum creatinine (Williams 27e).

Why does proteinuria occur in preeclampsia

Endothelial injury increases glomerular permeability allowing albumin leakage into urine (ACOG PB 222).

What hepatic change occurs in severe preeclampsia

Hepatic ischemia and periportal necrosis elevate AST/ALT and may cause subcapsular hematoma (Williams 27e).

How does preeclampsia lead to thrombocytopenia

Endothelial injury activates platelets and promotes microangiopathic hemolysis (ACOG PB 222).

What hematologic abnormality characterizes HELLP syndrome

Hemolysis, elevated liver enzymes, and low platelets due to widespread endothelial damage (Williams 27e).

Why can preeclampsia cause DIC

Disseminated activation of coagulation consumes platelets and clotting factors (ACOG PB 222).

What pulmonary complication may arise in severe preeclampsia

Pulmonary edema due to increased capillary permeability and reduced oncotic pressure (Williams 27e).

How does preeclampsia affect the brain

Cerebral vasospasm and edema lead to headache, visual changes, seizures, or eclampsia (ACOG PB 222).

Why does preeclampsia cause visual disturbances

Vasogenic edema in occipital lobes impairs visual pathways and may cause cortical blindness (Williams 27e).

What cardiovascular change occurs in preeclampsia

Increased systemic vascular resistance and afterload strain the left ventricle (ACOG PB 222).

How does preeclampsia impair uteroplacental circulation

Failure of spiral artery remodeling reduces uteroplacental perfusion and oxygen delivery (Williams 27e).

What are the fetal effects of uteroplacental insufficiency

Growth restriction, oligohydramnios, preterm birth, and intrauterine death (ACOG PB 222).

Why is the fetus growth-restricted in preeclampsia

Placental hypoperfusion limits nutrient and oxygen transfer (Williams 27e).

What is the perinatal mortality risk in preeclampsia

Increased due to preterm delivery, placental abruption, and fetal distress (ACOG PB 222).

How does preeclampsia predispose to placental abruption

Endothelial injury and vasospasm cause decidual bleeding and premature placental separation (Williams 27e).

What long-term maternal risk follows preeclampsia

Higher lifetime risk of chronic hypertension, ischemic heart disease, and stroke (ACOG PB 222).