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IV.

PATHOPHYSIOLOGY
Precipitating factor: Obesity Poor maternal nutrition Pre-existing hypertension Renal disease Defective placental implantation Endovascular trophoblastic cells invade the maternal spiral arteries Release of placental factor Fibrin, platelets and lipophages aggregates

Predisposing factors: Age-39 years old Hereditary -HPN

Replacement of endothelium, destruction of medical musculoelastic tissue, and fibrinoid change in the vessel wall

Increased platelet activation

Acute atherosis partially or completely blocking the arterioles

Increased thrombosane Placental infraction vasospasm Fetal distress Endothelial dysfunction Fetal death

Placental ischemia

Hypertension

vasoconstiction

Increase d BP=160/ 110mm Hg

Reduced perfusion of affected organs

kidney

Decrease GFR

Increase permeability of the glomerular membrane

Increase reabsorption in tubules

Decrease urine output Increase uric acid Increase creatine

proteinuria

Increase sodium retention + H2O

LEGEND: - Process - Signs & symptoms - Medication - Pathophysiological pathways

edema

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