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A suggestion about the cause of inflammation in acute atherosis complicating poor placentation in preeclampsia. The hypothesis is set forth that maternal release of epinephrine in the adrenal medulla causes systemic platelet activation (SPA) which, in turn, initiates coagulation via the intrinsic pathway and leads to thrombin generation. Thrombin causes inflammation, which is the underlying cause of acute atherosis in preeclampsia (PE). Each step of this cascade is examined in detail and supporting literature documented. SPA is associated with migraine headaches, which are a prominent clinical feature of PE and may help explain why PE is a risk factor for future maternal cardiovascular disease.

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