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1、PREECLAMPSIAReinaldoFigueroa,MDWinthrop-UniversityHospitalPREECLAMPSIAHypertensivedisorderspecifictopregnancyaffectsnearly6%ofallpregnanciesamajorcauseofmaternalandneonatalmortalityandmorbidity15to20%ofmaternalmortalityindevelopedcountriesPREECLAMPSIASeverityr

2、angesfrom:amilddisorder(transienthypertensioninthelaterpartofthepregnancy)toalife-threateningdisorderwithseizures,HELLPsyndrome,fetalhypoxia,andgrowthretardationmoreseveredisease:0.56per1000deliveriesPREECLAMPSIAPredisposeswomentootherseriouscomplications:plac

3、entalabruptionacuterenalfailurecerebralhemorrhagedisseminatedintravascularcoagulationcirculatorycollapsePREECLAMPSIATheetiologyisunknownbelievedtobeinvolved:immunemaladaptationplacentalischemiaoxidativestressgeneticsusceptibilityPREECLAMPSIAClassificationofhyp

4、ertensioninpregnancyGestationalhypertensionPreeclampsia/eclampsiaChronichypertensionPreeclampsiasuperimposedonchronichypertensionPREECLAMPSIADefinitionofhypertensionasystolicbloodpressureof140mmHgorabove,oradiastolicbloodpressureof90mmHgorabove,ontwooccasions6

5、hoursapartAbnormalproteinuriatheexcretionof300mgormoreofproteinin24hoursPREECLAMPSIACriteriaforseverepreeclampsiaBloodpressure:>160mmHgsystolicor>110mmHgdiastolicProteinuria:>5gin24hoursPersistentandseverecerebralorvisualdisturbances(headache,scotoma,blurredvi

6、sion)PersistentandsevereepigastricpainorrightupperquadrantpainPREECLAMPSIACriteriaforseverepreeclampsiaPulmonaryedemaorcyanosisOliguria(<500mLofurinein24hours)Eclampsia(grandmalseizures)HELLPsyndromePREECLAMPSIAScreeningtestsforgestationalhypertensionroutineco

7、mponentsofantepartumcaretrimesterearlydetectionofvasoconstrictionearlydetectionofalteredrenalfunctionearlydetectionofalteredhemodynamicsdetectionofplacentalhypoperfusion/ischemiadetectionofendothelialactivationorinjurydetectionofanactivatedcoagulation/fibrinol

8、yticsystemPREECLAMPSIAPreventionofpreeclampsiawomenatrisk:multifetalgestation,vascularorrenaldisease,previousseverepreeclampsia-eclampsia,abnormaluterinearteryDopplervelocimetryant