(精编)【高血压英文教学精品课件】 PREECLAMPSIA.pptVIP

PREECLAMPSIA Eclampsia - risk factors low socioeconomic status extremes in childbearing age African-American no prenatal care substance abuse PREECLAMPSIA Eclampsia - management control convulsions correction of hypoxia and acidosis blood pressure control delivery after maternal stabilization PREECLAMPSIA Reinaldo Figueroa, MD Winthrop-University Hospital PREECLAMPSIA Hypertensive disorder specific to pregnancy affects nearly 6% of all pregnancies a major cause of maternal and neonatal mortality and morbidity 15 to 20 % of maternal mortality in developed countries PREECLAMPSIA Severity ranges from: a mild disorder (transient hypertension in the later part of the pregnancy) to a life-threatening disorder with seizures, HELLP syndrome, fetal hypoxia, and growth retardation more severe disease: 0.56 per 1000 deliveries PREECLAMPSIA Predisposes women to other serious complications: placental abruption acute renal failure cerebral hemorrhage disseminated intravascular coagulation circulatory collapse PREECLAMPSIA Criteria for severe preeclampsia Blood pressure: 160 mmHg systolic or 110 mm Hg diastolic Proteinuria: 5 g in 24 hours Persistent and severe cerebral or visual disturbances (headache, scotoma, blurred vision) Persistent and severe epigastric pain or right upper quadrant pain PREECLAMPSIA Criteria for severe preeclampsia Pulmonary edema or cyanosis Oliguria ( 500 mL of urine in 24 hours) Eclampsia (grand mal seizures) HELLP syndrome PREECLAMPSIA Screening tests for gestational hypertension routine components of antepartum care trimester early detection of vasoconstriction early detection of altered renal function early detection of altered hemodynamics detection of placental hypoperfusion / ischemia detection of endothelial activation or injury detection of an activated coagulation / fibrinolytic system PREECLAMPSIA Prevention of preeclampsia women at risk: multifetal gestation, vascular or renal disease, previous severe preeclampsia-eclampsia, a