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References 1. Gilbert SJ, Weiner DE. National Kidney Foundation’s primer on kidney diseases. Sixth edition 2014; 430. 2. Thomas M Coffman et. al. Schrier’s Diseases of the Kidney, 9th ed. 2015; 1697-1700. 3. Pettit F, Brown MA. The management of preeclampsia: What we think we know. Eur J Obstet Gynecol Reprod Biol 2012; 160: 6-12. 4. Johnson RJ, Feehally J, Floege J. Comprehensive Clinical Nephrology 5th ed. 2014; p: 506-521. 5. Shachar BZ, Lyell DJ. Interpregnancy interval and obstetrical complications. Obstet Gynecol Surv 2012; 67: 584-596. 6. Conde-Agudelo A

INTRODUCTION Preeclampsia represents one of the hypertensive disorders of pregnancy (HDP) and one of the leading causes of maternal and perinatal morbidity and mortality worldwide complicating 2%-8% of pregnancies ( 1 , 2 ). According to the American College of Obstetricians and Gynecologists there are four major hypertensive disorders encompassed within HDP: 1) chronic hypertension, 2) preeclampsia and eclampsia, 3) hronic hypertension with superimposed preeclampsia, and 4) gestational hypertension ( 3 ). The International Society for the Study of Hypertension

References 1. Espinoza J, Uckele JE, Starr RA, et al. Angiogenic imbalances: the obstetric perspective. Am J Obstet Gynecol 2010;203(1):17.e1-8. 2. ACOG Committee on Obstetric Practice. ACOG Practice Bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33. January 2002. American College of Obstetricians and Gynecologists. Int J Gynecol Obstet 2002;77(1):67-75 3. Rasmussen LG, Lykke JA, Staff AC. Angiogenic biomarkers in pregnancy: defining maternal and fetal health. Acta Obstet Gynecol Scand 2015;94(8):820-32. 4. Staff AC, Dechend R, Redman CW

References 1. Catarino C, Santos-Silva A, Belo L, et al. Inflammatory Disturbances in Preeclampsia: Relationship between Maternal and Umbilical Cord Blood. J Pregnancy. 2012;2012: Article ID 684384. 2. Xiao JP, Yin YX, Gao YF, et al. The increased maternal serum levels of IL-6 are associated with the severity and onset of preeclampsia. Cytokine 2012;60:856-860. 3. Ouyang Y, Li SJ, Zhang Q, Cai H, Chen HP. Interaction Between Inflammatory and Oxidative Stress in Preeclampsia. Hypertens Pregnancy. 2009;28:56-62. 4. Guven M, Coskun A, Ertas IE, et al. Association of

References 1. Osungbade KO, Ige OK. Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening. J Pregnancy. 2011; 2011: 481095. 2. Madazli R, Bulut B, Tuten A, Aydin B, Demirayak G, Kucur M. First-trimester maternal serum metastin, placental growth factor and chitotriosidase levels in pre-eclampsia. Eur J Obstet Gynecol Reprod Biol. 2012 Oct;164(2):146-9. DOI: 10.1016/j.ejogrb.2012.06.016 3. Vitoratos N, Hassiakos D, Iavazzo C. Molecular mechanisms of preeclampsia. J Pregnancy. 2012; 2012:298343. DOI: 10

Abstract

Preeclampsia is a multisystemic disease with yet unknown etiology, specific only for human gestation and with symptoms like arterial hypertension, proteinuria and edema. The study group was composed by 65 pregnant women with gestational age between 38-40 weeks, which gave birth in Obstetrics and Gynecology Clinic of Constanta Emergency Clinical County Hospital, during January 2001 - July 2011 and was divided in two groups, A and B, depending on the blood pressure values measured during hospitalization. Group A was composed of 33 hypertensive pregnant women and group B was composed of 32 pregnant women with physiological pregnancy evolution. The retroplacental arterioles diameter was measured by specific methods of morphometry, the probes being obtained from myometrial tissue after caesarian section for both groups. Morphometric differences between spiral retroplacental arterioles of preeclampsia pregnant women and of those with physiological evolution during gestation certify the presence of incomplete structural parietal vessel wall changes in preeclampsia.

Introduction Preeclampsia, a multisystem disorder characterized by new-onset hypertension and either proteinuria or end-organ dysfunction after 20 weeks of gestation, affects 2 to 5% of pregnancies. 1 , 2 , 3 , 4 The ability to assess fluid status is fundamental for optimal management of preeclamptic patients. Insufficient intravascular volume results in decreased oxygen delivery to tissues and exacerbates organ dysfunction. 5 , 6 On the other hand, fluid excesses can lead to tissue edema due to extravascular fluid accumulation, which is especially

References 1. Murphy DJ, Striate GM. Mortality and morbidity associated with early-onset preeclampsia. Hypertens Pregnancy. 2000;19(2):221-31. 2. Noris M, Perico N, Remuzzi G. Mechanisms of disease: preeclampsia. Nat Clin Practe. 2005;1(2):98-114. 3. Shennan AH, Redman C, Cooper C, Milne F. Are most maternal deaths from preeclampsia avoidable? Lancet 2012;379:1686-7. 4. Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005;308(5728):1592-94. 5. Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium

REFERENCES 1. Rosser ML, Katz NT Preeclampsia: an obstetrician’s perspective. Adv Chronic Kidney Dis 2013, 20(3), 287-296. 2. Jerath R, Barnes VA, Fadel HE Mechanism of development of pre-eclampsia linking breathing disorders to endothelial dysfunction. Med Hypoth 2009, 73 (2), 163-166. 3. Tamás P, Ifi Zs, Szilágyi A Discordant clinical characteristics suggest different pathogenesis of praeeclampsia. J Perinat Med 2007; 35(suppl. 2): 278. 4. Maeda K Preeclampsia is caused by continuous sympathetic center excitation due to an enlarged pregnant uterus. J. Perinat

From a Meta-analysis of Twin Studies. Arch Gen Psychiatry. 2003; 60:1187-119. 72. Mak LE, Croy BA, Kay V, Reynolds JN, Rätsep MTB, Forket ND et al, Resting-state functional connectivity in children born from gestations complicated by preeclampsia: A pilot study cohort. Pregnancy Hypertens. 2018; 12: 23-28. 73. Pabalan N, Jarjanazi H, Sun C, Iversen AC, Meta-analysis of the human leukocyte antigen-G (HLA-G) 14 bp insertion/deletion polymorphism as a risk factor for preeclampsia Tissue Antigens. 2015; 86:186-94. 74. Hollister JM, Brown AS. Rhesus incompatibility and