What happens biologically during Pre-E

[laura]

Also this explains why there's no 'cure' for preeclampsia. BP meds don't work- because the high blood pressure is just the reaction to the problem.

So, the 20 million dollar question is: How would you fix it, after it has already started? How do you increase the blood flow to the baby without damaging something else?

So preeclampsia is essentially the reaction to something that happened probably before you even knew you were pregnant!

[laura]

And I can expound a little more, until we get our science chicks in here.

As Ileana describes, there's a problem with the placenta. Recent research has established that the blood vessels attaching the placenta to the uterus in preeclamptic women aren't as deep or strong as they should be.

This set up works fine for the first part of pregnancy, but often there's a point where the baby grows large enough that these puny little vessels don't supply as much blood as the baby needs. The body responds by racheting up the blood pressure. Well, hyperperfusion might work for getting more blood to the baby- but it is a bad long term strategy, as the increased blood pressure can cause organ damage (most commonly to the kidneys) but also to the placenta itself.

In an attempt to keep the organs from getting blasted by this pressure- the body then starts the vasospasm part- the blood vessels start shutting intermittently on their own-- which can cause a whole host of other problems, including further damage to the vessels and destruction of red blood cells and platelets.

Meanwhile, the vessels begin to show the strain by leaking from the pressure and vasospasm. The watery part of the blood seeps out of the veins and acumulates in the extremities, like hands and feet. The swelling can get extreme, and the extra fluid the body has to process further stresses the kidneys, that are already groaning under the increased blood pressure. If it gets extreme, the fluid doesn't get pushed out, the kidneys don't work as well, and the swelling becomes pathologic-- it can end up as pulmonary edema in the lungs, or around the heart, or the swelling can enter the cranium and compress the brain and cause strokes or hemmorages.

Yee.

Hope this helps!

[ileana]

I'm sure that there are others that understand and can explain the process better than I do, but they might not be able to get in here during the weekend. I read these things about 3 years ago, and I'm too lazy to go get quotes from books, but here's what I remember.

Preeclampsia is a disease of the placenta. I think that there are multiple mechanisms that can cause the placenta to get diseased, and there's a whole theory on what actually goes wrong. Anyway, in the end, the diseased placenta starts influencing the other organs.

There is no specific diagnostic test for preeclampsia/diseased placenta, but the most common systems that fail when preeclampsia strikes are the endothelium (which causes the hypertension and swelling) and the kidneys (causing them to start not filtering all the protein). Other systems that may fail are: liver - elevated liver enzymes causing right upper quadrant pain and epigastric pain, blood: low plateles and/or hemolisys, central nervous system: reflexes, visual disturbances, etc. Swelling can be that bad that it affects eyes and cause THE headache.

So basically when two or more systems start failing after 20w (when the placenta is fully functional), they diagnose preeclampsia.

Thanks for the great question! I hope this answers at least part of your question!

[princess purr]

I'm not a pro or a doc, but I think with the protien your kidneys are not working properly and not breaking down protein so it passes through your urine
With blood pressure I think you vessels are restricking and not relaxing making the pressure go with.
I'm not sure what causes hypereflexia but I had that majorly. Your reflexs are in over drive. The doc would just touch my knee and my leg would move.
Hopefully someone has better answers them me!

[abbie]

Okay ladies, I'm sure a lot of you have researched a ton about this disorder and may help to provide me some insight into what it really means to have Pre-E. I have a minor in bio/ and took lots of chem in college... but I have no clue how this works.

What exactly is happening that makes your BP rise and your protein to enter your urine? What do these symptoms do to your body chemically/biologically? Also, what's up with the hypereflexia - how does that enter the picture?

Any little tidbit of info would be great.

Thank you all in advance.

Abbie