B P International

Preeclampsia is defined as new onset hypertension and albuminuria in previously normotensive pregnant women after 20 weeks of pregnancy. There is no cure; management is reliant on a structured antenatal surveillance programme and antihypertensives. Recent advances in immune histochemistry study of placenta have elucidated an increased Vascular Endothelial Growth Factor (VEGF) expression in various placental bed disorders like recurrent pregnancy loss, preeclampsia, fetal growth restriction, preterm and abruption placenta. Increased release of VEGF family proteins has been attributed to atherosis and placental hypoxia. However, some studies have found normal VEGF concentrations in placenta in these disorders of feto-maternal interphase. This chapter aims to analyse the VEGF expression in placental biopsy from preeclampsia and normotensive pregnancies. VEGF density is more in the placentas from preeclampsia pregnancies as compared to placenta from a normal pregnancy. The mean weight...

Hypertensive  disorders  in  pregnancy  are  a  leading  cause  of  peripartum  morbidity  and  mortality. Preeclampsia is a heterogeneous maternal syndrome. Large  studies  have  pointed  out  the  association  of  impaired  spiral  artery  remodeling  at  the fetomaternal interphase in preeclampsia, but how exactly is the fetomaternal dialogue mediated and what are the biomarkers to detect the subclinical disease in various subsets of high-risk pregnancies is  still  a  challenge.  These  biomarkers  can  finally  be  used  to  diagnose  renal  function  (Kallikrein-creatinine ratio), vascular resistance (uterine artery Doppler), coagulation disorders (platelet volume, fibronectin,  prostacyclin,  thromboxane,  oxidant  stress  (lipid  peroxidase,  8-isopr...

Pregnancy  induced  Hypertension also  called as “Gestosis” plural “Gestoses” has a heterogeneous etiology.  A  case  of  atypical  eclampsia  with  seizures  in  the  postpartum,  that  required  intravenous Magnesium sulphate is described. The two proposed theories of etiopathogeniesis of cerebral edema, “Vasogenic  Theory”  and  “Cytotoxic  theory”  are  discussed.  The  concept  of  “delta  hypertension”  is emphasized.  Impaired  fluid  mobilization,  decreased  sodium  excretion  and imbalance  between angiopoietic  factors  in  the  post  partum  period  is  discussed  as  the  likely  cause  of  post  partum eclampsia. It can be concludedthat it is important to monitor blood pressure in the postpartum state. The  patient...