【高血压英文ppt精品课件】 hypertensive disorders in pregnancy

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1、HypertensiveDisordersinPregnancyAzzaAlyamaniProf.ofObstetrics&GynecologyClassificationWomenwhoarepregnantandhypertensivemustbedividedinto:*chronichypertension.*pregnancyinducedhypertension(PIH)orgestationalhypertension.thosewithPIHfurthersubdivided:*proteinuricPIH(preeclampsia)minorit

2、y*non-proteinuricPIHmajorityTherefore:womenwithhypertensioninpregnancyareclassifiedashaving:1.preeclampsia(proteinurichypertension).2.non–proteinurichypertension.3.chronichypertension:•primary(essential)hypertension.95%.•secondaryhypertension.5%...renaldis...adrenaldis...hyperthyroidis

3、m.Theaetiologyandmanagementofthethreeconditionsaredifferent.Incidence:Worldwide,maternalmortalityfromhypertensivediseaseaccountsfor:100.000deathsperyear.preeclampsiaoccursin5%.non–proteinuricPIH15%.itaccountsto15–20%ofmaternalmortalityinthedevelopedcuonteris.Definition:pregnancyinduced

4、hypertension(PIH)is:Hypertensionthatoccursafter20weeksgestationandunrelatedtootherpathology.protienuriaistheexcretionof300mgormoreofproteinin24hoursurine.hypertensionandprotienuriadefinepreeclampsia.Preeclampsia:*isamultisystemdisorderinvolvingtheplacenta,liver,kidneys,blood,neurologic

5、alandcardiovascularsystems.*bothmaternalandfetalmorbidity/mortalityaremorelikelytooccurwithearly–onsetdiseaseas;placentalabruption,acuterenalfailure,cerebralHge,DICandIUGR,prematurityasdeliveryistheonlycure.therefore,ANCisdirectedtowardsidentifyingwomenwithhypertensionandprotienuria.*s

6、everityrangesfrom:amilddisorder(transienthypertensioninthelaterpartofthepregnancy)toalife-threateningdisorderwithseizureHELLPsyndrome,fetalhypoxia,andgrowthretardation.*moreseveredisease:0.5per1000deliveriesChronicHypertension:isthepresenceofpersistenthypertensionofwhatevercause,before

7、20weeksgestationorpersistenthypertensionbeyond6weekspostpartum.sustainedbl.pof140/90mmHgor>ontwooccasions6hoursapartisconsideredhypertensive.AetiologyPregnancyinducedhypertension(PIH)Preeclampsia:isunknown,believedtobeinvolved:=immunemaladaptation.=placentalischemia.=oxidativestress.