PATHOPHYSIOLOGY (Book Based) Non Modifiable Factors: Age ( <20 - >40 y/o) Family history of Eclampsia Gender (Female)

male) Primiparity Race/Ethnicity

Modifiable factors: Diet and nutrition Lifestyle

Defective placental implantation Release of placental factor Factor X Endovascular trophoblastic cells invade the maternal spiral arteries Replacement of endothelium, destruction of medial musculoelastic tissue, and fibrinoid change in the vessel wall Fibrin, platelets, lipophages aggregates Acute atherosis partially or completely blocking the arterioles Placental infarction

Placental ischemia

Increase platelet activation

Increased thromboxane A2

Vasospasm Vasoconstriction

Increased blood pressure

Decreased perfusion to organs

Kidney Decreases glumerular filtration rate Increased creatinine, increased uric acid, decreased urine output

Pancreas

Brain Cerebral alteration Hyperreflexia, seizure

Placenta Fetal distress

Eyes Hemorrhage Blurring of vision

Increased permeability of the glumerular membrane Proteinuria

Increased reabsorption in tubules Increased Na and water retention Edema

Epigastric pain

Stillbirth

PATHOPHYSIOLOGY (Patient Based) Non Modifiable Factors: Age ( 21 y/o) Family history of Eclampsia Gender (Female) Primiparity

Modifiable factors: Diet and nutrition Lifestyle

Defective placental implantation Release of placental factor Factor X Endovascular trophoblastic cells invade the maternal spiral arteries Replacement of endothelium, destruction of medial musculoelastic tissue, and fibrinoid change in the vessel wall Fibrin, platelets, lipophages aggregates Acute atherosis partially or completely blocking the arterioles Placental infarction

Placental ischemia

Increase platelet activation

Increased thromboxane A2

Vasospasm Vasoconstriction

Increased blood pressure

Decreased perfusion to organs

Kidney Decreases glumerular filtration rate Increased creatinine, decreased urine output

Pancreas

Brain

Placenta

Eyes Blurring of vision

Increased permeability of the glumerular membrane Proteinuria

Increased reabsorption in tubules Increased Na and water retention Edema