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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
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