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BMSC3146 > Preeclampsia > Flashcards

Preeclampsia Flashcards

1
Q

Preeclampsia is defined as..

A

An abnormal condition of pregnancy characterised by onset of acute hypertension after the 24th week of gestation

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2
Q

Signs of preeclampsia

A

Hypertension
Proteinuria
Oedema

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3
Q

Percentage of all pregnancy affected by preeclampsia

A

5-8%

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4
Q

Incidence of PE increases with

A

Gestational age of mother

Multiple gestations

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5
Q

Mild form of PE

A

Systolic BP >140mmHg and diastolic >90mmHg

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6
Q

Severe form of PE

A

Systolic BP >160mmHG and diastolic >110mmHg

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7
Q

First stage of defective trophoblast invasion

A

Occurs early in pregnancy

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8
Q

Uteroplacental circulation remaining in a state of high resistance can be detected by..

A

Increased resistance of the uterine arteries

Albaiges et al., 2000

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9
Q

Persistant state of underperfusion produces..

A

Placental hypoxia and oxidative stress

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10
Q

Systemic inflammatory response and endothelial dysfunction leads to..

A

the onset of clinical symptoms of PE

Ness and Roberts, 1996

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11
Q

Studies show PE disease with strong familial predisposition

A

Reported that women with first-degree relatives with PE have 5 times more risk of developing
Those with second-degree have double the risk
(Graves 1998, Salonen 2000)

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12
Q

Goddard et al 2007 study

A

Evaluated 775SNPs in 190 genes in >350 PE mother and offspring pairs

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13
Q

Goddard et al 2007 detected..

A

6 genes with a significant maternal-foetal genotype interaction related to PE

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14
Q

Goddard et al 2007 6 genes..

A 
IGF1
IL4R
GNB3
CSF1
THBS4
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15
Q

Multifactorial polygenic inheritance with..

A

A genetic component in the development of PE

Trogstad et al., 2004

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16
Q

Uteroplacental variations in renin-angiotensin system

A

ACVR2

STOX1

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17
Q

Placental angiogenesis heritable variations

A

PIGF
VEGF
Flt-1
Endogelin

18
Q

Sovio et al study

A

Showed that the ratio of sFlt to PIGF can be used as a predictive value of PE

19
Q

Single association signal close to Fms-like tyrosine kinase 1 on what chromosome

A

13

20
Q

Fms-like tyrosine kinase 1 encodes

A

Soluble Fms-like tyrosine kinase 1

a splice variant of the VEGF

21
Q

What does soluble Fms-like tyrosine kinase

A

Exerts antiangiogenic activity by inhibiting signalling of proangiogenic factos

22
Q

Fms-like tyrosine kinase 1 pathway is central in preeclampsia pathogenesis because..

A

Excess circulating soluble Fms-like tyrosine kinase 1 in the maternal plasma leads to hallmark features of PE
(Gray et al 2018)

23
Q

Obesity increases overall risk of preeclampsia by..

A

2-3 fold

Bodnar et al 2005

24
Q

Risk of preeclampsia increases with..

obesity

A

Increasing BMI

25
Q

Increased risk of PE is present in..

A

Caucasian and African-American women

Bodnar et al 2007

26
Q

Features of obesity that provide insight into pathophysiology of PE

A

Inflammation

Oxidative stress

27
Q

Inflammation and PE

A

Adipose tissue generates several inflammatory mediators that can alter endothelial function
Produced more actively in obese individuals

28
Q

Circulating C-reactive protein are

A

Inflammatory mediators produced by the liver as well as adipocytes

29
Q

Circulating C-reactive proteins are elevated in..

A

Early pregnancy prior to development of PE

30
Q

Wolf et al 2001 showed

A

Strong assocation with PE and obese women

circulating C-reactive proteins

31
Q

Interleukin-6 is a

A

Potent inflammatory mediator

32
Q

Interleukin-6 leads to

A

Vascular damage and is associated with obesity and insulin resistance
Grimble 2002

33
Q

Tumour necrosis factor alpha (TNF-α) is also produced in adipose tissue BUT

A

Studies have shown that TNF-α is not higher in obese pregnant women compared to non-obese controls
Founds et al 2008

34
Q

Autophagy plays an important role in..

A

Trophoblast function under physiologically low oxygen conditions in normal pregnancy

35
Q

Autophagy is a process of..

A

Self-degradation of cellular components in which double-membrane autophagosomes sequester organelles and fucse with lysosomes so that the contents can be digested by lysosomes
Mizushima et al 2010

36
Q

Autophagy is important in

A

Extravillous trophoblasts (EVT) invasion and vascular remodelling under physiologically low oxygen conditions

37
Q

EVTS invade the..

A

Uterine myometrium up to 1/3 in depth and migrate along the lumina of spiral arterioles replacing the maternal endothelial lining

38
Q

Autophagy impaired by sENG may be involved in..
(4 things)

Saito and Nakashima 2013

A

Poor placentation due to impairedEVT invasion and poor vascular remodelling
Systemic inflammation by activating inflammasome and induction of ER stress
Inadequate tolerance by reducing the pool of Treg cells in PE

39
Q

Cure of PE

A

Delivering the baby

NHS, 2018

40
Q

Treatment for severe PE

A

Hospitalisation and complete bedrest
High protein diet to compensate for loss of protein and increase nutrients for foetus
Magnesium sulphate (4-7.5 mEg/L) helps excretion of fluid to reduce BP and in more severe cases stop convulsions and seizures

41
Q

Complications

A

High mortality if undiagnosed
Risk of cerebral haemorrhave
Circulatory collapse
Renal failure

BMSC3146 (10 decks)

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