[医学]妊娠期高血压.ppt

Introduction Hypertensive states complicate 8-11% of all pregnancies It may cause maternal and fetal morbidity and remain a leading source of maternal mortality What is hypertensive state ? What is hypertensive state It includes: gestational hypertension. preeclampsia-eclampsia☆ chronic hypertension chronic hypertension with superimposed preeclampsia Case Study You have been seeing a 23-year-old woman, gravida 1,para 0,at 31weeks of gestation, throughout her pregnancy. She has no known medical history. She denies blurry vision, epigastric or right upper quadrant pain, severe headache, or trouble breathing, Her blood pressure and urine protein dipstick results for past three visits are as follows : visit1,BP=105/60,Udip=0;visit2,BP=130/90,Udip=1+; visit3,BP=140/95,Udip=1+. Today her BP=165/100 and Udip=3+. She reports lots of fetal movement. Lungs are clear auscultation bilaterally. The most accurate diagnosis for this patient Definitions Gestational hypertension(Transient hypertension): Hypertension is defined as a systolic blood pressure level of 140mm Hg or higher or a diastolic blood pressure level of 90 mm Hg or higher that occurs after 20 weeks of gestation in a woman with previously normal blood pressure and with normalization of blood pressure postpartum[12 weeks].. As many as one quarter of women with gestational hypertension will develop proteinuria, ie, preeclampsia. Definitions Preeclampsia: A syndrome defined by hypertension and proteinuria that also may be associated with myriad other signs and symptoms, such as edema, visual ? disturbances, headache,laboratory abnormalities… most of all they occur after 20 weeks gestation, rare some special cases can occurring before 20 weeks gestation. Ep. Hydatidiform mole. Eclampsia: The occurrence of seizures that can not be attributed to other causes in a preeclampsia patient Definitions Chronic hypertension: Blood pressure exceeding 140/90 mm Hg before conception or before 20 weeks gestation or th