In the pathophysiology of pre-eclampsia, failure of trophoblast invasion of spiral arteries results in which of the following characteristic placental vascular changes?

• A Persistence of muscular and elastic tissue in the walls of spiral arteries
• B Fibrinoid necrosis of decidual arterioles with complete physiologic transformation
• C Physiologic conversion of spiral arteries into high-resistance, low-capacitance vessels
• D Failure of physiologic transformation, leaving spiral arteries as high-resistance, low-capacitance vessels ✓

Explanation

In pre-eclampsia, trophoblast invasion is shallow and incomplete. The spiral arteries retain their muscular walls and fail to undergo physiologic transformation into low-resistance, high-capacitance vessels. This leads to placental hypoperfusion and ischemia, triggering release of anti-angiogenic factors. Option A describes the normal state in the non-pregnant uterus. Option B describes the normal physiologic change of pregnancy. Option C reverses the correct relationship.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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