Medicine an Surgery notes

Apr 24th, 2015
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Hypertension in PregnancyTeresa G. Berg, M.D.Maternal-Fetal MedicineUniversity Medical AssociatesOBJECTIVESList criteria for the diagnosis ofpreeclampsiaList criteria for the diagnosis of severepreeclampsia/HELLP syndromeDiscuss current managementconsiderationsHypertensionSustained BP elevation of 140/90 or greaterProper cuff sizeMeasurement taken while seatedUse 5th Korotkoff soundForms of HTN in PregnancyGestational HypertensionFormerly called Pregnancy-InducedHypertensionNo proteinuriaForms of HTN in PregnancyGestational HypertensionPreeclampsiaHypertension with proteinuriaMay have other evidence of end-organ diseaseEdemaVisual changesHeadacheEpigastric painLaboratory changesOlder Criteria for GestationalHTN30/15 increase in BP over baseline levelsNo longer appropriate73% of patients will exceed 30 mm systolicand 57% will exceed 20 mm diastolicPatient CategoriesPatient with HypertensionElevated BP abovefirst trimesterlevels55-75%Gestational hypertensionNo proteinuriaPreeclampsiaHypertension25%Proteinuria5-8% of prognanciesForms of HTN in PregnancyGestational HypertensionPreeclampsiaChronic HypertensionAs a group these occur in 12 to 22% ofpregnant patients and are directlyresponsible for approximately 18% ofmaternal mortality nationally.Chronic HypertensionPre-existing h

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