Medicine an Surgery notes

Apr 24th, 2015
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HYPERTENSIVE DISORDERS IN PREGNANCYDefinition: Elevated BP in pregnancy or within 6 wks (42days) oftermination of pregnancy with or without proteinuria observedon 2 occasions 6 hrs apart Hypertensive disorders complicating pregnancy are commonand form one of the deadly triad, along with hemorrhage andinfection that results in much of the maternal morbidity andmortality related to pregnancy. Proteinuria is defined as the excretion of 300 mg or more in a24-hour specimen or 30mg/dL in a random specimen.Classification of HIP: There are four major hypertensive disorders related topregnancy based on onset of BP rise and proteinuria1. Preeclampsia Formerly called pregnancy-induced hypertension Pre-eclampsia: BP and proteinuria after 20 wks occurring afterthe 20th gestational week and most frequently near term Eclampsia: Coma or convulsions that cannot be explained byother causes in a preeclamptic patient.2. Chronic hypertension Chronic hypertension (or preexisting hypertension) is defined assystolic pressure 140 mmHg, diastolic pressure 90 mmHg, orboth, that antedates pregnancy, is present before the 20th weekof pregnancy, or persists longer than 12 weeks postpartum. It can be primary (essential hypertension) or secondary to avariety of medical disorders.3. Preeclampsia superimposed upon chronic hypertension Superimposed preeclampsia is diagnosed when a woman withpreexisting hypertension develops new onset proteinuria afte

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