HYPERTENSION IN PREGNANCY——妇产科学.ppt

HYPERTENSION IN PREGNANCY Department of Obstetrics and Gynecology Wu Jie Key Points ???? Introduction ?????Classification ?????Pathophysiology ?????Clinical findings Management INTRODUCTION Hypertension in pregnancy is generally defined as blood pressure of at least 140/90 mm Hg (hydrargyrum) or a rise of 30 mm Hg systolic blood pressure or 15 mm Hg diastolic blood pressure. INTRODUCTION Hypertension affects 7% to 10% of all pregnancies. Subsequent maternal and fetal morbidity and mortality may be incurred. Acute complications may be suffered by the pregnant woman. Complications of hypertension account for 15% of all maternal deaths in the U.S. Key Points ???? Introduction ?????Classification ?????Pathophysiology ?????Clinical findings Management Q: What is the classification of “Pregnancy-Induced Hypertension ” in Chinese textbook? CLASSIFICATION Preexisting or chronic hypertension Gestational hypertension (Transient hypertension) Preeclampsia Eclampsia Chronic hypertension with superimposed preeclampsia Chronic hypertension with superimposed eclampsia NORMAL BLOOD PRESSURE FOR PREGNANCY 9-17 weeks of gestation systolic pressure: 111±5 mm Hg diastolic pressure: 65±4 mm Hg 31-40 weeks of gestation systolic pressure: 115±8 mm Hg diastolic pressure: 70±6 mm Hg Chronic hypertension Hypertension appears before 20 weeks of gestation or presents beyond 6 weeks after delivery Chronic hypertension complicates 1% to 3% of pregnancies High risk to develop superimposed preeclampsia or eclampsia Chronic hypertension Table 1 Clinical Findings Suggestive of Chronic Hypertension Multiparity with a history of hypertensive pregnancies Retinal hemorrhages Blood urea nitrogen concentration 20 mg/dl Radiographic or electrocardiographic evidence of cardiac enlargement Presence of diabetes mellitus, renal disease, or other predisposing disorders Chronic hypertension Table