SEARCH RESULTS FOR: Pre-Eclampsia-Pathogenesis

Pre-Eclampsia Pathogenesis

Pre-Eclampsia: Pathogenesis Pregnant person risk factors Fetal risk factors Imbalance of Th17/Treg cells and other inflammatory or immune factors Aberrant activation of innate immune cells creates a cytotoxic environment in utero (exact mechanism unclear) Primigravida (1st pregnancy) Advanced maternal age Genetic factors (e.g. sFLT1) Collagen vascular disease Previous preeclamptic pregnancies Multiple gestation Other unclear causes Dysregulated immune and non-immune decidual cells (specialized endometrial cells) promote abnormal placental trophoblast invasion and uterine spiral artery formation (exact mechanism unclear) Multiple unclear, complicated mechanisms Abnormal association of placental vasculature with uterine vasculature early in pregnancy (utero-placental mismatch) disrupts adequate blood perfusion from placenta to fetus (< 20 weeks gestation or early-onset) Fetus experiences under- perfusion, hypoxia, ischemia, and oxidative stress Placental cells release molecules toxic to vascular endothelium into the maternal circulation Damaged maternal blood vessels are less able to perfuse the placenta Systemic dysfunction of maternal blood vessel endothelium (endothelial cell activation) (>20 weeks gestation or late-onset) Inflammatory cells retain memory postpartum which increases risk for developing preeclampsia in subsequent pregnancies Hypoxia leads to placental cell death, which results in release of fetal antigens Authors: Yan Yu Jasmine Nguyen Reviewers: Kayla Nelson Radhmila Parmar Sean Spence Monica Kidd* Katrina Krakowski* Maryam Nasr-Esfahani* Riya Prajapati Michelle J. Chen Jadine Paw* * MD at time of publication Placental ischemia & injury Pre-existing maternal diseases damage endothelial cells (e.g. vasculitis, diabetes, renal diseases, chronic hypertension) Placenta is unable to supply sufficient O2 and nutrients to meet demands of growing fetus Maternal Clinical Findings and Complications** Fetal Clinical Findings and Complications** **See corresponding Calgary Guide slides Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Feb 10, 2017; updated Nov 22, 2024 on www.thecalgaryguide.com