homeostasis - Homeostasis in Pre Eclampsia Eclampsia...

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Homeostasis in Pre Homeostasis in Pre Eclampsia Eclampsia Mohammad A Emam Mohammad A Emam Prof. of Obstetrics and Gynecology Mansoura Faculty of Medicine Member of Mansoura integrated fertility center (MIFC) Faculty of Medicine, Mansoura University - Egypt 2003
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Toxaemia Of Pregnancy Toxaemia Of Pregnancy Zweifel (1916) Termed toxaemia the disease of theories Many Classifications (change of toxaemia) National High Blood Pressure Education Programme, (2000)
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Traditional Diagnosis Of Traditional Diagnosis Of pre eclampsia (PET) pre eclampsia (PET) Hypertension Hypertension + + Proteinuria Proteinuria = = Two facets of a complex pathophysiological Two facets of a complex pathophysiological process process
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The Constant Pathological The Constant Pathological Feature Feature Is Is Vascular endothelial damage , dysfunction and spasm (wolf et al, 2001)
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Homeostasis Homeostasis Homeo= same & stasis= standing Homeo= same & stasis= standing (Fox 1999) (Fox 1999) Steady internal environment (ECF) Steady internal environment (ECF) Regulations: Regulations: -Intrinsic -Intrinsic -Extrinsic -Extrinsic (Guyton 2000) (Guyton 2000)
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Homeostatic Control Homeostatic Control Systems Systems Negative Feed back ( Stablity ) Positive Feed back ( Amplification ) (Vender et al, 1998)
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Central Players in PET Central Players in PET (Homeostats) (Homeostats) 1. The Endothelium 2. Neutrophils 3. Platelets 4. Coagulation system Once one is triggered Others are activated. Many co- workers are initiated (NO, PGs, ROS, Homocystein, Endothelins, VEGF, etc)
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Endothelial Paradox Endothelial Paradox 1. Thrombogenic 2. Thrombolytic 3. VC 4. VD (Hayman et al, 2000)
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Neutrophil Activation Neutrophil Activation Vicious Circle + ve feedback loop Vicious Circle + ve feedback loop
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Coagulopathies in PET Coagulopathies in PET Difference Difference DIC DIC Micro- angiopathy Micro- angiopathy Aetiology Thromboplastin, thrombin, fibrin Endothelial cell damage, platelet activation, deficient
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homeostasis - Homeostasis in Pre Eclampsia Eclampsia...

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