الفهرس 
PathophysiologyOnly 14 pages are availabe for public view
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Abstract
ypert-ensive disorders zoinplicat-ing pregnancy ;riii;c:t 8-1 0’;;. ot’ all regn~ncies and continue to be responsible, together with haemorrhage and infect-in, for the largpt number of ma term1 deaths.The incidence of pre eclanipsia is cotnnionly cited to be about 5 percent, althougl-t remarkable variations are reported. The incidence is influeiiceil by pari tv, age, riici~lg, ene tic and environ~nentn l factors . Abnormal tro~hoblast-ictu nci-ion is 1-hought to cor,ti-ib~iie1 -0 thr development of pre-eclampsia. Although the significance of trophoblas t function in this disease is not well understood. Troyhoblasts of norn~ai pregnancy enhanced blood flow to thij placenta by invading and remodeling the uterine arteries into lowresistance c11,tnnels. Inadequate trophoblastic invasion of the n~!:iimetrinl spirzl arteries lead to pre-eclampsia through diminished at-eroplacentai blood flow, vasospasm, and endothelial cells insult. The precise underlying biochemical defects that promote abnorn-tal troylioblastic behavior and subsequent enilothelial cell dysfunction art3 unkno~m. The vascular chi~nges, together with local h\.posia of the surrounding tissues, yresulxably lr~dto hetnurrl~~~rgirrz crosis L~ni’: other end-organ disturbances that have been obser\:ed ’:t tin~es with severe pre-eclampsia . LVhen the diagn~siso f hypertension is made ciuri:~gp regnancy, the ictus is alreadj~ in a con~promised environment. Intrauterinr growth retardation (IUGII) ns well as a certain nun-tbc.:. ot premature deliveries and periri;~t;il ~ie~1t11a,rie; directly !-rIclird tu f~\;perte~tsiij:o. pregn;tnc);, 111ostky 11; iisso~laticill \.\;ith prt! t)Cciiiiit)>ic The signs mcl syiriptrrls of pre-eciampsi;~ be~:ul;le apparent ii:. relatively late stage in pregnancy, usually in the third trirnestei-. I--Iowever, the urtderlying cause of the patl~oph~siologimc echanis~m. that are thought to be respo~~siblfeo r the disease process, appear tc.1 occur much earlier i!~ pregnancy. Emerging possibilities of preven tivr:. of pregnancy induced hypertensive disorders stress the need hr ci reliable and simple test for early identificatit.jl; of pregnant \;L1uillei; with high risk. More than hundred ciinical, biophysical c~~b~ioccihe mical test havt. been reported in the cwrid literattlre to predict the future development of pre-eclampsia. Man!; of t!me tests were ret)ie.rved concerning thy idea of the test, its inethod of implicarioll, the srnsitivlty al’lii specificity . On identifying women at high risk oi PIH bv the ROT, man\- reports suggested effective prediction of gestational hypertensio~. using the ROT on nulliparous patients between 28-32 weeks, gestatioli. I--Ien~atocritv alue significantly increase in patient having preeclampsia, there was pr(3gressive elevation of hematoerite vid~wsw ith the severity of pre-eclanlpsia but this elevatiiln vccured iate after tilt. appearance of symytv~nsa nd signs of pre-eclampsia. Serum uric acid levels inc-;-eased in ~twr~e[i\.:it 11 preeclan~ysiaC IIIL~ demonstrated a psit i\?r i.orreia:ion betweel; :he mag- nitude of seru~s uric acid levels and ilinicoi se\:rr.it?; of pre-esi,~mpsi;~. . . The tern\ l:~i~y~)ll~~jy~:,t[:~i,iLl)~C:h z.~ 1~;;111luyl >[I t.k~.L~ii’ciiiyO I~L immunologic all^ related high nlolcli.ul;li- wrigl~tg lyci-,yrc!teirts that art, present ill blood and other boil\; fluids. Also existing on n~arty cell surfaces, in extracellular fluids, in c-ortnective tissues and in most basement membranes.