1.Pathogenesis Endothelial cell injury Imbalance between prostacyclin and thromboxane Rejection phenomenon:allograft Compromised placental perfusion Altered vascular reactivity Decreased glomerular filtration rate with retention of salt and water
1. Pathogenesis • Endothelial cell injury • Imbalance between prostacyclin and thromboxane • Rejection phenomenon: allograft • Compromised placental perfusion • Altered vascular reactivity • Decreased glomerular filtration rate with retention of salt and water
Decreased intravascular volume Increased central nervous system irritability Disseminated intravascular coagulation Uterine muscle stretch Dietary factors:calcium deficiency Genetic factors
• Decreased intravascular volume • Increased central nervous system irritability • Disseminated intravascular coagulation • Uterine muscle stretch • Dietary factors: calcium deficiency • Genetic factors
pathogenesis Immunologic disturbance 1 abnormal placental implantation decreased placental perfusion ↓ Production of substances Injure or activate endothelial cell
pathogenesis Immunologic disturbance abnormal placental implantation decreased placental perfusion Production of substances Injure or activate endothelial cell
2.Pathophysiology Arteriolar brain:petechial hemorrhage, Vasospasm ischemia edema eyes:serous retinal detachment pulmonary system:edema Leakage cardiovascular system: glomerular exudation high resistance,low output, capillaries ischemia,infarction,failure spasm,ischemia, plasma volume:not increase permeability kidney:Glomeruloendotheliosis AldosteroneT liver:fibrosis,infarction HELLP Retension placenta:insufficiency,abruptio of water,Na+ blood:thrombocytopenia,DIC, hemoconcentration Hypertension proteinuria edema
2.Pathophysiology glomerular capillaries spasm, ischemia, permeability ischemia brain: petechial hemorrhage, edema eyes: serous retinal detachment pulmonary system: edema cardiovascular system: high resistance, low output, ischemia, infarction,failure plasma volume: not increase kidney: Glomeruloendotheliosis liver:fibrosis, infarction HELLP placenta:insufficiency, abruptio blood:thrombocytopenia, DIC, hemoconcentration Aldosterone↑ Retension of water, Na+ Hypertension proteinuria edema Leakage exudation Arteriolar Vasospasm
3.Predisposing factors: Nulliparity Black race Maternal age <20 or >35 Low socioeconomic status Multiple gestation Hydatidiform mole Polyhydramnios Nonimmune fetal hydrops Diabetes Chronic hypertension Underlying renal disease Family history
3. Predisposing factors: – Nulliparity – Black race – Maternal age <20 or >35 – Low socioeconomic status – Multiple gestation – Hydatidiform mole – Polyhydramnios – Nonimmune fetal hydrops – Diabetes – Chronic hypertension – Underlying renal disease – Family history