Fundamentals
Pathophysiology
Abnormal trophoblast invasion of spiral arteries leads to incomplete remodeling and placental ischemia. Ischemic placenta releases anti-angiogenic factors (sFlt-1, sEng) that bind and neutralize VEGF and PlGF, causing systemic endothelial dysfunction. This leads to vasospasm, increased permeability, and end-organ damage. Cerebral vasospasm and posterior reversible encephalopathy syndrome (PRES) underlie seizures.
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