Which of the following best describes the primary placental pathological event in early-onset pre-eclampsia?

• A Excessive spiral artery dilation leading to placental hyperperfusion
• B Villous edema secondary to fetal anemia
• C Acute atherosis confined to the decidua parietalis
• D Failure of trophoblast invasion with incomplete transformation of spiral arteries ✓

Explanation

In pre-eclampsia, cytotrophoblast fails to invade the maternal spiral arteries adequately, so the physiological conversion from muscular vessels to flaccid low-resistance sacs remains incomplete. This causes uteroplacental hypoperfusion, ischemia, and release of antiangiogenic factors such as sFlt-1. Acute atherosis may accompany the process but is a secondary lesion, not the initiating event.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.