Which histologic findings characteristic of preeclampsia?

Updated: Jun 12, 2018
  • Author: Michael P Carson, MD; Chief Editor: Edward H Springel, MD, FACOG  more...
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Endothelial dysfunction and vasospasm observed in preeclampsia affect multiple regions of the body, including the maternal brain, kidneys, liver, lungs, heart, and placenta. Pathology demonstrates areas of edema, microinfarctions, and microhemorrhage in the affected organs.

The placenta typically shows in situ thrombosis and decidual vasculopathy/incomplete decidualization of the spiral arterioles, which may be part of the pathogenesis of preeclampsia. This can affect the fetus via decreased uteroplacental blood flow. The decrease in flow can manifest clinically as nonreassuring fetal heart rate testing, low score on a biophysical profile, oligohydramnios, and fetal growth restriction.

The kidneys may reveal glomerular endotheliosis that is associated with proteinuria greater than 300 mg in 24 hours or, more rarely, acute tubular necrosis (ATN) or cortical necrosis.

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