妊娠高血压疾病-陈晓军-英文教学课件PPT.pptVIP

HELLP syndrome Hemolysis blood smears show RBC debris Hb 60-90g/L TB20.5μmol/L Elevated serum level of Liver enzymes AST70u/L, or 3SD LDH600u/L Low Platelets PLC100*109/L HELLP Severe preeclampsia ： One abnormalities 6% Two abnormalities 12% Three abnormalities 10% 20 gw seldom occur 1/3 occur after delivery 80% diagnosed prenatally HELLP——clinical diagnosis Might be asymptomatic pain in the right upper abdomen 80% weight gain or severe edema 50-60% 20% cases 140/90 mmHg 6% cases without proteinuria Some investigatiors regard HELLP syndrome as an entirely distinct disease entity from preeclampsia Classification of HELLP By degree of thrombocytopenia： 50,000/mm3 50,000 – 100,000/mm3 100,000/mm3 Not widely accepted Pathogenesis and epidemic characteristics of HELLP core mechanism endothelial injury——intravascular coagulation dysfunction predisposing factors the white multipara elder pregnant women HELLP--mortality Maternal 0-24% hepatorrhexis DIC Acute renal failure thrombosis cerebrovascular accidents Perinatal 7.7-60% Premature delivery IUGR placental abruption Eclampsia process： tonus convulsion sleepiness coma Occurrence prenatal intrapartum postpartum * * Hypertension Disorders Complicating Pregnancy 妊娠期高血压疾病 Hypertensive Disorders complicating Pregnancy Gestational Hypertension Preeclampsia Preeclampsia Superimposed on Chronic Hypertension Chronic Hypertension Eclampsia A Group of Related Diseases Characteristics Systemic small arteries spasm Endothelial cell injury Hypertension Proteinuria Multiple organs dysfunction Convulsion Maternal mortality Fetal mortality Gestational Hypertension; Chronic hypertension Eclampsia Preeclampsia; Preeclampsia Superimposed on Chronic Hypertension Hypertension disorders complicating pregnancy Pathophysiology Category and clinical manifestation Diagnosis and differential diagnosis Management and prevention 病理生理 临床表现 诊断 治疗 Epidemiology Incidence： 6-9% Preeclampsia-eclampsia： 70% Chronic Hyperten