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Reduced placental perfusion

Reduced Uteroplacental Perfusion Pressure (RUPP) causes

Reduced placental perfusion is thought to contribute to the development of preeclampsia 3, resulting in the development of the reduced utero-placental perfusion pressure (RUPP) model 4, in which.. The vascularity index, as assessed by perfusion measurement of the placenta, was reduced after doxycycline treatment in preeclamptic rats. Thus, matrix metalloproteinase inhibition with doxycycline leads to reduced trophoblast invasion and associated reduced placental perfusion Myometrial and placental artery reactivity alone cannot explain reduced placental perfusion in pre-eclampsia and intrauterine growth restriction. Ong SS(1), Moore RJ, Warren AY, Crocker IP, Fulford J, Tyler DJ, Gowland PA, Baker PN Preeclampsia is a potentially fatal hypertensive disorder of pregnancy that is initiated by reduced placental perfusion. Increased sympathetic tone may contribute to the hypertension, since basal muscle sympathetic nerve activity is clearly increased above the levels observed in normal pregnant women [4] A more gradual decrease in spiral artery perfusion might increase ischemic adaptation or syncytiotrophoblast injury with fibrinoid deposition, but not caused infarction. This inverted infarction pattern would only be detectable if the fetus is delivered long enough after the hypotension for coagulation necrosis to become evident

Inhibition of trophoblast-induced spiral artery remodeling

/ Serelaxin improves the pathophysiology of placental ischemia in the reduced uterine perfusion pressure rat model of preeclampsia. In: American Journal of Physiology - Regulatory Integrative and Comparative Physiology. 2016 ; Vol. 311, No. 6. pp. R1158-R1163 An initiating event in PIH has been postulated to be reduced placental perfusion that leads to widespread dysfunction of the maternal vascular endothelium by mechanisms that remain to be defined. 1-4 The mechanisms leading to reduced placental perfusion in PIH may be multiple, but most studies in humans suggest abnormal cytotrophoblast. Potential outcomes of poor placental medical attention. perfusion include a malnourished, LBW infant, and prematurity associated with early delivery, abruptio placentae, and fetal death. Reduced fetal activity indicates fetal compromise (occurs before detectable alteration in FHR and indicates need for immediate evaluation/intervention

Myometrial and placental artery reactivity alone cannot

Evidence continues to implicate reduced placental perfusion as the cause of preeclampsia, initiating a sequence of events leading to altered vascular function and hypertension. The present study was designed to determine the influence of reduced uteroplacental perfusion pressure (RUPP) on the responsiveness of uterine arcuate resistance arteries. A condition of RUPP was surgically induced in.

Ineffective Tissue Perfusion. Placenta Previa causes painless and continuous bleeding. With bleeding, there is decreased Hemoglobin. Hemoglobin carries oxygen to different parts of the body. If there is decreased hemoglobin there is a failure to nourish the tissues at the capillary level. Assessment. Patient may manifest. Restlessness. / Natural killer cells contribute to mitochondrial dysfunction in response to placental ischemia in reduced uterine perfusion pressure rats. In: American journal of physiology. Regulatory, integrative and comparative physiology. 2019 ; Vol. 316, No. 5. pp. R441-R447 Placental insufficiency is a blood disorder marked by inadequate blood flow to the placenta during pregnancy. If blood flow is restricted, the infant is unable to receive adequate nutrients and oxygen, making it difficult for the baby to grow and thrive while in the womb. The earlier this condition surfaces in pregnancy, the more serious the. Impairment of uterine spiral artery remodeling is associated with decreased placental perfusion, increased uterine artery resistance, and obstetric complications such as preeclampsia and intrauterine growth restriction

H 2 S-releasing molecule, MZe786 reduced renal oxidative

PubMed journal article: Myometrial and placental artery reactivity alone cannot explain reduced placental perfusion in pre-eclampsia and intrauterine growth restriction. Download Prime PubMed App to iPhone, iPad, or Androi Placental insufficiency can cause severe injury to the baby. As blood flow (perfusion) becomes more and more deficient and the baby becomes increasingly oxygen deprived - or poor perfusion and oxygen deprivation continue for an extended period - the baby develops a high likelihood of having acidemia at birth Decreased cardiac output will lower uterine perfusion pressure. Moreover, the lower aorta may also be compressed further decreasing utero-placental perfusion. To remedy this situation, the mother is placed in the right or left lateral position to decrease the pressure from the gravid uterus on the great vessels An initiating event in preeclampsia has been postulated to be reduced placental perfusion that leads to widespread dysfunction of the maternal vascular endothelium by mechanisms that remain to be defined (see Figure) The reduced uteroplacental perfusion (RUPP) model, via partial occlusion of the lower abdominal aorta, mimics insufficient placental perfusion as a primary causal characteristic of preeclampsia

Placenta Perfusion - an overview ScienceDirect Topic

While the description of the patterns of placental injury associated with maternal vascular pathology have not changed significantly, the change in terminology was made to reflect that maternal vascular pathology may not lead simply to underperfusion, but also abnormal perfusion, including high velocity and turbulent blood flow 3. Other. Decreased tissue perfusion can be temporary, with few or minimal consequences to the health of the patient, or it can be more acute or protracted, with potentially destructive effects on the patient. When diminished tissue perfusion becomes chronic, it can result in tissue or organ damage or death zone can produce the lesions of placental MVM (10). The mechanisms by which defective deep spi-ral artery remodeling leads to placental and fetal pathologic effects is complex and not fully under-stood. As in other organ systems, reduced blood flow secondary to reduced vascular capacity or vas-cular occlusion leads to hypoxic-ischemic injury Placental insufficiency or utero-placental insufficiency is the failure of the placenta to deliver sufficient nutrients to the fetus during pregnancy, and is often a result of insufficient blood flow to the placenta.The term is also sometimes used to designate late decelerations of fetal heart rate as measured by cardiotocography or an NST, even if there is no other evidence of reduced blood.

A major initiating event leading to the development of PE is thought to be reduced placental perfusion that leads to widespread dysfunction of the maternal vascular endothelium by mechanisms that remain to be determined (8, 28, 31). Although the symptoms of PE typically appear after the 24th week of gestation, and this syndrome is diagnosed in. The reduced uteroplacental perfusion (RUPP) model, via partial occlusion of the lower abdominal aorta, mimics insufficient placental perfusion as a primary causal characteristic of preeclampsia. However, a major limitation of the RUPP model is that perfusion is reduced to the entire hindquarters of the rat resulting in hindlimb ischemia A significant correlation between areas of reduced placental perfusion and fetal size was demonstrated (p=0·041, Spearman's rank correlation). Interpretation. Non-invasive imaging of placental perfusion by means of EPI has potential as a clinical tool in assessing the dynamics of placental perfusion

if high bp, what is risk for fetal injury from reduced placental perfusion secondary to vasospasm? 1 doctor answer • 3 doctors weighed in. Share. Dr. Thomas Riney answered. Pediatrics 37 years experience. IUGR: Intrauterine growth retardation can be caused by decreased blood flow to the placenta The human placenta, like the sheep placenta, is a relatively inefficient oxygen exchanger. Thus, in humans and sheep, the transfer rate of oxygen is affected less by decreases in placental perfusion than the transfer rate in animals with more efficient placentas, such as the rabbit and guinea pig significant roles in uterine remodeling, vasodilation and placental development (Facemire, 2009). In this study, the surgical Reduced Uterine Perfusion Pressure (RUPP) pregnant rat model is used because of its similarities in utero-placental under-perfusion of preeclampsia in humans. The RUPP model has replicated the maternal hypertension The three major modifiers of placental transfer function are maternal blood flow, fetoplacental blood flow, and placental trophoblast membrane permeability. By extension, factors that can limit fetal oxygenation, nutrition, and metabolism are (1) altered maternal perfusion, (2) altered fetoplacental perfusion, (3) reduced placental permeability. This is supported by an ex vivo study of placental perfusion from human fetal growth-restricted pregnancies, where flow mediated vasodilation was reduced but NOS3 was still elevated . This combination of normal vascular resistance with decreased umbilical blood flow appears to be a unique distinction between CSH RNAi induced IUGR and other.

Our data demonstrate that a 50% reduction in dietary protein throughout gestation results in reduced placental perfusion, fetal growth restriction, and a 50% rate of pregnancy loss. In addition, we demonstrate reduced total protein content and evidence of fetal hypoxia in the amniotic fluid Preeclampsia (PE) is a pregnancy-induced hypertension with proteinuria that typically develops after 20 weeks of gestation. A reduction in uterine blood flow causes placental ischemia and placental release of anti-angiogenic factors such as sFlt-1 followed by PE. Although the reduced uterine perfusion pressure (RUPP) model is widely used in rats, investigating the role of genes on PE using.

Preeclampsia is Associated with Abnormal Uteroplacental Blood Flow. It has been hypothesized that preeclampsia arises from reductions in uteroplacental perfusion, leading to fetoplacental ischemia (82, 83).The mechanisms leading to reduced placental perfusion in preeclampsia are not clear, but studies in humans implicate impaired first-trimester cytotrophoblast invasion of spiral arterioles as. Question: Create A Nursing Care Plan For A Person On Risk For Fetal Injury Related To Reduced Placental Perfusion Secondary To Vasospasm. This problem has been solved! See the answer. Create a Nursing Care Plan for a person on Risk for fetal injury related to reduced placental perfusion secondary to vasospasm A low pressure system with high blood flow into the placenta is therefore created and optimum placental perfusion is maintained. Trophoblastic invasion of the spiral arteries is prevented in pre-clampsia, resulting in reduced placental perfusion, which can potentially lead to early placental hypoxia Placental Insufficiency. When a mother has placental insufficiency, there is a lack of adequate blood flow to the baby, which can cause the baby to have intrauterine growth restriction (IUGR), oligohydramnios, and nutrient and oxygen deprivation. When this occurs, the baby's brain can suffer brain damage, hypoxic-ischemic encephalopathy (HIE), cerebral palsy, and seizures

Video: Chapter 9 Placental Perfusion: Section D Placental

OBJECTIVES: (1) To investigate a possible association between myometrial and placental artery vasoreactivity and perfusion at the basal and chorionic plates, respectively. (2) To confirm that myometrial arteries from women with pre-eclampsia and intrauterine growth restriction exhibit an attenuated endothelium-dependent vasodilatory response Placental perfusion can be compromised by as much as 50% in mothers who ingest cocaine. Decreased fetal oxygen levels have also been noted with maternal cocaine exposure Failure of the uterine spiral artery remodeling results in reduced placental perfusion; subsequently, placental factors are released into the maternal circulation that can lead to the dysfunctional activity of the endothelial cells (Salomon et al., 2014)

Reduced Uterine Perfusion Pressure (RUPP) Model for

Decrease in placental blood flow results in reduced gas exchange and impaired nutritional functioning of the placenta. Potential outcomes of poor placental perfusion include a malnourished, LBW infant, and prematurity associated with early delivery, abruptio placentae, and fetal death WASHINGTON - In pregnancies complicated by fetal congenital heart disease (CHD), global placental perfusion was significantly decreased and regional variation of placental perfusion significantly increased as pregnancies progressed, findings that point to non-invasive imaging providing an early warning of placental dysfunction. A Children's National Health System research team is thought. Cerebroplacental ratio (CPR) is an obstetric ultrasound tool used as a predictor of adverse pregnancy outcome in both small for gestational age (SGA) and appropriate for gestational age (AGA) fetuses. An abnormal CPR reflects redistribution of cardiac output to the cerebral circulation, and has been associated with intrapartum fetal distress, increased rates of emergency cesarean and NICU. These aberrations lead to reduced uteroplacental perfusion and placental ischemia, with consequent increased systemic release of pro-inflammatory cytokines and Introduction Preeclampsia (PE) is a severe placenta-related syndrome exclusive of human pregnancy that represents the main cause of feto-maternal mortality and morbidity worldwide [1,2] Absent or reversed UA end diastolic flow is not observed until 60%-70% of the placenta is affected. It is important to recognize that the mechanisms that lead to abnormal elevation of umbilical (and uterine artery) Doppler index are the histologic properties of the placental vascular bed resulting in decreased perfusion

The team was able to distinguish the placenta perfusion contributions by the fetus and the mother. In pregnancies complicated by fetal CHD, global placental perfusion significantly decreased and. Doppler ultrasound provides a non-invasive method for the study of fetal hemodynamics. Investigation of the uterine and umbilical arteries gives information on the perfusion of the uteroplacental and fetoplacental circulations, respectively, while Doppler studies of selected fetal organs are valuable in detecting the hemodynamic rearrangements that occur in response to fetal hypoxemia The placental ischemic reduced uterine perfusion pressure (RUPP) rat model of preeclampsia exhibits many of these features. In this study, we examined the maternal outcomes of AT1-AA inhibition (n7AAc′) in RUPP rats. Blood pressure was higher in RUPP rats versus normal pregnant (NP) rats (123±2 versus 99±2 mm Hg, P<0.05), which was reduced.

Placental Insufficiency: Causes, Symptoms, and Diagnosi

placental perfusion leading to ischemia may be the common source of this disease.1 In the placenta of preeclamptic women, trophoblast invasion does not occur and blood flow is reduced, resulting in placental hypoxia. In addition, increased amounts of soluble Flt1 (sFlt1) are produced by the placenta and scavenge VEGF and PlGF, thereby. Purpose: To assess placental perfusion and permeability in mice with magnetic resonance (MR) imaging. Materials and Methods: This study was conducted according to French law and National Institutes of Health recommendations for animal care. Twenty-two pregnant BALB/c mice were examined at 1.5 T with a single-section dual-echo fast spoiled gradient-echo sequence placenta. Prolonged labor prior to delivery causes maternal physiologic compromise, resulting in fetal depression due to decreased placental perfusion, hypoxemia and acidosis. Maternal and puppy mortality is significantly increased during emergent versus planned CS (1,2). Timing and preparation are extremel C21 treatment effectively decreased HIF1α expression and partially improved placental and fetal weights in T dams, indicating that C21-mediated improvement in UA blood flow and placental perfusion and oxygenation could have contributed to the beneficial effect in T dams

Cardiac system struggles to pump against increased peripheral resistance -> reduced blood supply to organs (kidneys, pancreas, liver, brain, & placenta) Mild = BP 140/90, proteinuria +1, transient headaches (or none), reduced placental perfusion Severe = BP 160/110, proteinuria +2 or +3, hyper-reflexia, urine output less than 400-500mL/24hr. A, EC tube formation was decreased in reduced in other models of pregnancy-induced hypertension11,16 or oth- utero-placental perfusion pressure (RUPP) rats compared with erwise complicated pregnancies with angiogenic imbalance.25 normal pregnant (NP) controls To determine the capacity of the fetus to adapt to chronic O 2 deficiency produced by decreased placental perfusion in the early development of growth retardation, we embolized the umbilicial placental vascular bed of fetal sheep for a period of 9 days. Fetal umbilical placental embolization decreased arterial O 2 content by 39%, decreased total placental blood flow by 33%, and produced a 20%.

the uterus and reduced the uterine artery resistance index, suggesting improved placental perfusion. Introduction Abnormal placentation sets the stage for the development of pregnancy complications that may present with devastating maternal and fetal outcomes. The mechanisms that regulat Reduced uterine perfusion pressure (RUPP) model of preeclampsia in Mice. Tomofumi Fushima, Akiyo Sekimoto, Takahiro Minato, Takuya Ito, Yuji Oe, Kiyomi Kisu, Emiko Sato, Kenichi Funamoto, Toshiyuki Hayase, Yoshitaka Kimura, Sadayoshi Ito, Hiroshi Sato, Nobuyuki Takahashi We hypothesized that the hypertension produced by reduced uterine perfusion pressure (RUPP) is associated with increased sFlt-1 expression and decreased plasma vascular endothelial growth factor and placental growth factor concentrations in the pregnant rat

Schematic diagram of the fetal-placental tissue

Ex vivo human placental perfusion model. After 3 hr, fluorescence intensity decreased to 75 ± 4% of the initial signal for the plain 50-nm, 76 ± 2% for the plain 240-nm, 83 ± 4% for the COOH 50-nm, and 84 ± 5% for the COOH 300-nm PS beads, but then remained stable up to 72 hr (see Supplemental Material, Figure S1A).. Reduced uterine perfusion was initiated at day 14 of gestation with arterial pressure determined at day 19 of gestation in conscious, chronically instrumented rats. event in many of the features observed in women with preeclamp- preeclampsia is suggested to involve reduced placental per- sia.14,16 -18 Furthermore, these NO blockade. Those stillbirths born SGA were more likely to have decreased placental weight, infarcts, calcium deposition and greater than 2 and 3 placental outcomes. These placental findings have been associated with poor placental perfusion and may represent cases of placental insufficiency prior to demise associations between uterine artery PI and placental perfusion assessed by both FAIR and IVIM. Conclusion: Pregnancies that result in SGA neonates exhibited reduced placental perfusion as assessed by MRI during the second trimester. This measurement was found to be strongly associated with impedance to flow in the uterine arteries

Uteroplacental Blood Flow - OpenAnesthesi

perfusion were performed mid-gestation (gestational day 85 [G85] where term is G168) and in the early third trimester (G135). Our data demonstrate that a 50% reduction in dietary protein throughout gestation results in reduced placental One common consequence is the placental and fetal responses to decreased utero-placental blood flow, which will be discussed in Section 9c and 9E. The placenta in toxemia induces active signals in the maternal blood that oppose endothelial growth factor and results in damage endothelial cells

Reduced Uteroplacental Perfusion Alters Uterine Arcuate

Journal of Emerging and Rare Diseases - Archive

The proposed underlying mechanisms include interference with trophoblast differentiation, inadequate placentation, or thrombosis of the placental vasculature, with consequent reduced placental perfusion, oxidative stress, and maternal endothelial dysfunction that is believed to trigger the hallmark biological and clinical manifestations of. This can cause the placenta to be unable to deliver enough nutrients and oxygen to the fetus. Chronic placental insufficiency can also result in decreased delivery of calories to the fetus with intrauterine growth delay. Functions of the Placenta During Pregnancy . The placenta is a unique and complex product of human reproductive biology Eclampsia is diagnosed in pregnant women who develop novel seizures. Our laboratory showed that the reduced uterine perfusion pressure (RUPP) rat model of preeclampsia displays reduced latency to drug-induced seizures. While acid sensing ion channels (ASIC1a and 3) are important for reducing seizure longevity and severity, the role of ASIC2a in mediating seizure sensitivity in pregnancy has. Perfusion of the Pregnant Patient. To provide cardiopulmonary bypass to patients which suffer clinical cardiac disease during their pregnancy. When this cardiac disease has become exacerbated and surgical intervention becomes necessary, it should be carried out as early in the second trimester as possible following: (1) the conclusion of first trimester organogenesis; (2) prior to maximal.

Decreased organ perfusion Intravascular fluid redistribution Activation of coagulation cascade Vasoconstriction Vasospasm Systemic resistance Decreased plasma volume and perfusion Endothelial cell activation Hypertensive Disorders: Pre-E, Eclampsia, HELLP - Decreased placental perfusion - IUG The methods quantified an increase in mean placental blood volume and relative blood flow from gestational day (GD) 14 to GD18, while the mean transit time of the microbubbles decreased, demonstrating an overall rise in placental perfusion during gestation In pregnancies complicated by fetal congenital heart disease, global placental perfusion was significantly decreased and regional variation of placental perfusion significantly increased as. There was a significant decrease in ADC values of brain regions (p = 0.018) and placenta (p = 0.005) of conjoined twins compared to the control group. The decreased ADC values in placenta and brain regions in conjoined twins might be due to decreased placental perfusion compared to singleton pregnancy Objectives The coexistence of two complex physiologies such as Fontan and pregnancy is still not fully understood. We aim to add a unique and essential knowledge to help our colleagues in the management of Fontan patients that undergo pregnancy as well as the fetus and the placenta perfusion. Methods and results We analyse the coexistence of Fontan and pregnancy physiology on a complex case of.

Preeclampsia Hypertensio

Characterisation of cardiac health in the reduced uterine

  1. PURPOSE: To quantitatively analyze placental perfusion by using magnetic resonance (MR) imaging with contrast agents in a mouse model. MATERIALS AND METHODS: Study was conducted according to French law and in full compliance with National Institutes of Health recommendations for animal care. Thirty-six pregnant Balb/c mice at 16 days of gestation were injected intravenously with either a.
  2. This reduced perfusion of the placenta results in placental ischemia. This study sought to develop and characterize a mouse model of placental ischemia. Like preeclampsia patients and the rat placental ischemia model, reduced utero- Fig. 3. The effect of reduced uterine perfusion on erum sFlt-1 levels at day 18 of gestation in pregnant mice.
  3. Placental perfusion studies were performed for up to 6 h, which has been previously shown to be sufficient to detect placental translocation of various nanoparticles [36,37,38,39,40]. To achieve meaningful results and avoid potential adverse effects due to overload conditions, we aimed to investigate realistic exposure concentrations
  4. Significance: Placenta is an essential organ for fetal development and successful reproduction. Placental insufficiency can lead to fetal hypoxia and, in extreme cases anoxia, leading to fetal death. Of the 145 million deliveries per year worldwide, ∼15 million neonates are small for gestational age and, therefore, at risk for antepartum and intrapartum hypoxia
  5. The team was able to distinguish the placenta perfusion contributions by the fetus and the mother. In pregnancies complicated by foetal CHD, global placental perfusion significantly decreased and regional variation of placental perfusion significantly increased with advancing gestational age, says Dr Zungho Zun, the study's lead author
  6. decreased surface area of gas exchange at site of placental detachment. Placenta previa is the development of placenta in the lower uterine segment, partially or completely placental perfusion. • Prevents tearing of placenta if placenta previa is the cause of bleeding
  7. The placenta is a complex fetal organ that fulfills pleiotropic roles during fetal growth. It separates the maternal and fetal circulation, with which it is in contact through different surfaces, i.e., the syncytiotrophoblast exposes the placenta to the maternal circulation and the endothelium is in contact with fetal blood. Because of this unique position, the placenta is exposed to the.

In pregnancies complicated by fetal congenital heart disease, global placental perfusion was significantly decreased and regional variation of placental perfusion significantly increased as pregnancies progressed, findings that point to non-invasive imaging providing an early warning of placental dysfunction The placentae from these women were collected after delivery and vascular responses to dilator and constrictor agonists assessed using an in vitro placental perfusion method. At 18 wk gestation, umbilical artery flow velocity waveforms were significantly reduced in the moderate and severe asthmatic groups and in those women using high-dose. We sought to test the hypothesis that placental ischemia increases oxidative stress which in turn, contributes to hypertension. Methods: Reduction in uterine perfusion pressure (RUPP) was induced by placing silver clips on the abdominal aorta and the ovarian arteries on day 14 of pregnancy Quercetin was reported to be crucial for a broad range of activities, including attenuating inflammation, platelet aggregation, capillary permeability, and lipid peroxidation. However, the effect of quercetin in hypertension during pregnancy, was not fully understood. The model of hypertension in pregnancy was established in rats by reduced uterine perfusion pressure (RUPP)

The placental perfusion method is the only experimental method that has been used to study human placental transfer of substances in organized placental tissue. The aim of this article is to review human placental perfusion data on antiepileptic drugs CiteSeerX - Document Details (Isaac Councill, Lee Giles, Pradeep Teregowda): Purpose: We developed a new model for in vivo placental perfusion measurements based on dynamic MRI in mice. As noradrenaline has been implicated in the pathogenesis of preeclampsia, we examined whether it reduced placental perfusion in mice, and whether such a reduction could be detected with our MRI model

Credit: Children's National Health System. WASHINGTON - (Jan. 4, 2018) - In pregnancies complicated by fetal congenital heart disease (CHD), global placental perfusion was significantly decreased and regional variation of placental perfusion significantly increased as pregnancies progressed, findings that point to non-invasive imaging providing an early warning of placental dysfunction Myometrial and placental artery reactivity alone cannot explain reduced placental perfusion in pre-eclampsia and intrauterine growth restriction By Stephen S. Ong, Rachel J. Moore, Averil Y. Warren, Ian P. Crocker, Jon Fulford, Damian J. Tyler, Penny A. Gowland and Philip N. Bake Neither oxygen nor glucose consumption by the tissue was significantly reduced during the period of perfusion. The releasing rates of hCG and hPL did not change significantly during perfusion. The development of this dual perfusion system for the human placenta can provide for the study of placental hemodynamics and transplacental transport in. The recirculating dually perfused ex vivo placental perfusion model was performed as previously described with some modifications (Grafmüller et al. 2013; Grafmueller et al. 2015). Briefly, a fetal artery-vein pair of an intact cotyledon was cannulated, and the placenta was placed into a perfusion chamber with the maternal side up

Serelaxin improves the pathophysiology of placental

Hypertension Produced by Reduced Uterine Perfusion inRole of Mitochondrial Dysfunction and Reactive OxygenPPT - PREECLAMPSIA & ECLAMPSIA PowerPoint Presentation