妊娠性高血压(英文).pptx

Hypertensivedisordersofpregnancy(HDP)

(Pregnancy-inducedHypertensionsyndrome，PIH)

;;;Etiology:

1.Utero-placentalischaemia:

Abnormaldevelopmentoftheplacentalbedvessels/shallowtrophoblastinvisioninspiralarteries/acutearterosis/

2.Endothelialcellactivation/dysfunction:

Cytotoxicfactors:oxygenfreeraicals/lipidperoxidation/verylowdensitylipoprotein(VLDL)/fibronection/plateletderivedgrowthfactor(PDGF)/tumornecrosisfactor-a(TNF-a)/interleukins-6(IL-6)/anti-vascularendothelialfactor/endothelialinhibitivefactor

3.Immunity;

(1)??failtoexpressHLA-GmRNAorprotein.

(2)??abnormalmaternalimmunesituationsuchasTs/ThdecreaseandTh1functiondominent.

4.Genetics:

generecessivetrait.

;

Pathophysiology:

Basicpathophysiologychanges:spasmofthearterioles---activation/damageofendothelium---reducedorganperfusion:Hypertension/???Proteinuria/Edema

Pathology:hemorrhage/ischemia/necrosis/

1.????Placenta:

(1)??prematureagingofvilli

(2)??hemorrhage

(3)necrosis

;

2.????Kidney----glomerularchanges

(1)??swellingofendothelialcells

(2)??thedepositionofamorphousmaterialsincytoplasm

produceenlargement

(3)??swellingoftheglomerularcapillarities.

3.???Liver:periportalareas

4.Brain:cortical/subcorticalareas

5.Heart:increaseofcardiacafterload,preloadmay?or?.

6.Hematologicalchanges:hypercoagulationstatus,

HELLP(hemolysis,elevatedliverenzymes,lowcountplatelets)

;Clinicalfinding;DiagnosisofHDP;DIAGNOSISOFHYPERTENSION

;MEASUREMENTOFPROTEINURIA;DIAGNOSISOFCLINICALLYSIGNIFICANTPROTEINURIA;HELLPsyndrome;CLASSIFICATIONOFHDP;分类和诊断;子痫前期诊断（中国版）;重度子痫前期（中国版）;子痫前期诊断（ACOG，2013）;ACOG新版子痫前期严重性;CLASSIFICATIONOFHDP;;Preeclampsia

;INVESTIGATIONSTOCLASSIFYHDP;;PREDICTINGPREECLAMPSIA

;PreventingPreeclampsiaanditsComplicationsinWomenatLowRisk;;Preventing