PREDISPOSING FACTORS: Etiology: unknown

>Primigravida
>Obesity >Chronic Stress
>Hx of HPN >Younger than 20 or older than 40
>Multiple pregnancies >Lower socioeconomic status
>H-mole >History of preeclampsia
>Hx of DM
Peripheral arteriolar
Vasoconstriction

↓ Blood supply and O2

Perfusion to vital organs
HEART

HPN 160/90 BP
↑ Afterload KIDNEY January 19, 2010 LIVER VASCULAR AND
PLACENTA
HEMATOLOGIC
SYSTEM
↓ Cardiac Output Tissue Ischemia
RAAS Glomerular ↓ Glomerular Tissue
Degeneration Filtration Rate Ischemia
↓ Perfusion Hemolysis
Release of
thromboplastin- Renin ↑ Glomerular Permeability
like substance ↑ Tubular
reabsorption of Na Vascular Stasis Platelet aggregation
Weakness Fibrin deposition
Angiotensinogen Albumin & Globulin cross
01/21/10 Premature placental into urine
deterioration H2O Epigastric
retention Pain
Angiotensin I Proteinuria: 2+
Myocardial 01/19/10 ↑ ALT
↑ AST
Ischemia
Grade 3 pitting Urine Output of 500-
↓ fetal Fluid diffusion edema on both 700 per 24 hours
ACE 01/22/10
nutrients lower extremities
Abrutio
01/19/10
Placenta ↓ Platelets

IUGR Circulatory
System
Extracellular Generalized H2O Liver edema
space Retention
Angiotensin II Aldosterone
 Fetal Distress

Lungs Heart Brain HELLP

↑ Peripheral Reabsorption of syndrome
MI vascular sodium and water
PTL and resistance Cerebral
delivery Pulmonary Congestion
Edema Edema
Grade 3
pitting edema
Cardiac failure on both lower Cerebral DIC
160/90 BP CHF congestion
extremities
January 19, 2010 01/19/10
↑ Cerebral
Platelets are
Irritability
consumed

Right Temporal
Headache: 7/10 Convulsions
MATERNAL DEATH AND Hemorrhage
01/21/10
FETAL DEATH