Normal Trophoblast Invasion of Spiral Arteries
Placeholder: healthy pregnancy remodels spiral arteries into high-flow vessels.
- Deep: Invasion depth (placeholder note)
- Wide: Artery diameter (placeholder note)
- Low: Vascular resistance (placeholder note)
- Normal: Placental flow (placeholder note)
Two-wave trophoblast invasion
Placeholder: trophoblasts invade decidua then myometrial segments in two waves.
Muscular wall replacement
Placeholder: smooth muscle and elastic lamina replaced by fibrinoid material.
Shallow and Incomplete Trophoblast Invasion
Placeholder: in preeclampsia, invasion stalls at the decidual segment only.
- Shallow: Invasion depth (placeholder note)
- Narrow: Artery diameter (placeholder note)
- High: Vascular resistance (placeholder note)
- Unremodeled: Myometrial segment (placeholder note)
Failed second-wave invasion
Placeholder: second invasion wave into myometrium is defective or absent.
Persistent vascular reactivity
Placeholder: retained smooth muscle keeps arteries narrow and reactive.
Placental Ischemia and Oxidative Stress
Placeholder: narrowed arteries cause intermittent placental hypoperfusion.
- Low: Oxygen tension (placeholder note)
- Elevated: Oxidative markers (placeholder note)
- High: Syncytiotrophoblast stress (placeholder note)
- Intermittent: Perfusion pattern (placeholder note)
Hypoxia-reoxygenation injury
Placeholder: fluctuating perfusion generates reactive oxygen species.
Syncytiotrophoblast damage
Placeholder: stressed trophoblast releases debris and inflammatory signals.
Anti-Angiogenic Factor Release (sFlt-1)
Placeholder: ischemic placenta secretes sFlt-1 and soluble endoglin into circulation.
- Rising: sFlt-1 level (placeholder note)
- Falling: Free VEGF/PlGF (placeholder note)
- Elevated: Soluble endoglin (placeholder note)
- High: sFlt-1/PlGF ratio (placeholder note)
VEGF/PlGF sequestration
Placeholder: sFlt-1 binds and neutralizes pro-angiogenic VEGF and PlGF.
Systemic circulation entry
Placeholder: factors spill from placenta into maternal bloodstream.
Systemic Endothelial Dysfunction
Placeholder: maternal endothelium is damaged, producing preeclampsia symptoms.
- Elevated: Blood pressure (placeholder note)
- Present: Proteinuria (placeholder note)
- Impaired: Endothelial integrity (placeholder note)
- Reduced: Vasodilation capacity (placeholder note)
Loss of vascular tone control
Placeholder: endothelial damage impairs nitric oxide-mediated vasodilation.
Multi-organ manifestations
Placeholder: kidney, liver, and brain endothelium affected systemically.
Clinical outcome
Placeholder: hypertension and proteinuria define preeclampsia diagnosis.
Placeholder: delivery of the placenta remains the definitive treatment.