Pathophysiology of Preeclampsia

Pathophysiology of Preeclampsia and Rationale for Early Delivery of the Fetus as the Best Therapeutic Approach

ACKNOWLEDGEMENT

I would like to take this chance for thanking my research facilitator, friends and family for the support they provided me and their belief in me as well as guidance they provided without which I would have never been able to do this research.

DECLARATION

I, (Your name), would like to declare that all contents included in this dissertation stand for my individual work without any aid, and this dissertation has not been submitted for any examination at academic as well as professional level, previously. It is also representing my very own views and not essentially those that are associated with the university.

Signed __________________ Date _________________

ABSTRACT

The incidence of complications during pregnancy is commonplace these days. There are varieties of factors which pave way for complicated pregnancies. In this research, we tried to explore the concept of preeclampsia in a holistic context. The main focus of the research is on Pathophysiology of preeclampsia and its overall effects on the health of a pregnant woman and the child to be born. This research would focus on the therapeutic approaches to dealing with preeclampsia and assess the complications associated with it. If the problems are overlooked they can develop into serious complications which can even turn out to be fatal if proper treatment is not given. According to estimates, approximately 5 percent to 10 percent pregnancies experience complications because of hypertension. The Hypertension which has linkage with pregnancy is a heterogeneous complex of a variety of conditions which are pathophysiologic in nature. Chronic hypertension leads to a heightened BP (>140/90mmHg) twenty weeks prior to the gestation and continues even after six weeks of childbirth. Hypertension leads to other disorders in 90 percent of cases, with secondary causes like that of disorders of the endocrine and connective tissues, vascular renal diseases and parenchymal, etc. Preeclampsia is quite a complex clinical syndrome qualified by edema and hypertension that come along after twenty weeks of gestation in antecedently normotensive females. The acute lengthy process of vasospastic occurs in preeclampsia which in turn leads to endothelial injury. As a result, the adherence to platelet and the deposition of fibrin becomes potential of affecting any organ in the body. This research would conduct an in-depth analysis of Pathophysiology in preeclampsia. Also, the therapeutic approaches to early delivery which serves to be the best option in order to overcome further complications will also be discussed.

Table of Contents

ACKNOWLEDGEMENTII

DECLARATIONIII

ABSTRACTIV

CHAPTER 1: INTRODUCTION1

Background of the Study1

Rationale2

Significance of the Study3

Aims and Objectives of the Study4

Research Questions4

CHAPTER 2: LITERATURE REVIEW5

What is Preeclampsia?5

Causes8

Other ethiopathogenics18

Anatomy19

Kidney19

Liver19

Placenta20

Central nervous system20

Clinical20

Classification of preeclampsia22

Mild preeclampsia22

Eclampsia22

Treatment23

Pharmacotherapy Experimental24

Prophylaxis or treatment of convulsions25

Analgesia and anesthesia26

Delivery26

Others27

Treatment of HELLP Syndrome27

Forecast27

Complications28

Maternal Complications28

Fetal Complications28

Prevention29

The extravillous trophoblasts29

The normal decidualization33

The molecular mechanisms of trophoblast migration34

Loss of trophoblast invasion in preeclampsia35

The downstream consequences36

The consequences upstream36

Fetus, placenta and uterus38

Diagnosis39

Epidemiology40

Causes41

Pathophysiology43

Treatment43

The history44

Crisis44

Differential diagnosis45

Complications45

Treatment and prevention45

Immunotolerance45

Antenatal care strategies46

Screening for preeclampsia in the first quarter?50

Prevention Strategies52

CHAPTER 3: METHODOLOGY54

Introduction54

Sample Size and Population57

Materials and Methods58

Discussion63

CHAPTER 4: DISCUSSION AND ANALYSIS75

Epidemiology76

Pathogenesis -Current model78

Pathophysiology of Preeclampsia82

Primary Placental Pathology82

Cardiovascular ...