MBchB study guide

Apr 28th, 2015
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Pregnancy-induced Hypertensionsyndrome(Hypertensive disorderscomplicating pregnancy)Professor of obstetrics and gynecologyLin Qi DeTerm :PIHs is an acute or specific hypertension of pregnancywhich is peculiar to pregnant or puerperalwomen .Diagnosis of PIHs is made on the basis ofdevelopment of hypertension with or withoutproteinuria ,edema ,or both after the twentieth week ofgestation ,although the signs and symptoms mayappear earlier with hydatidiform moles . Classification : 1. Mild : Bp 140/90mmHg or Bp has a rise of 30mmHgsystolic pressure or 15 mmHg diastolic pressure (4/2 Kpa ) overthe prepregnant level,with or without trace proteinuria or edema. (= 1. gestational hypertension) 2. Moderate :Bp <160/110 mmHg (<21.3/14.6 Kpa ) ,withproteinuria + or edema . (= 2. preeclampsia/mild) 3. Severe : Bp 160/110 mmHg (21.3/14.6Kpa), with proteinuria++ or edema . (= 2. preeclampsia/severe) (1) preeclampsia : above-described signs with headache ,visualdisturbances and tightness of chest.(= 2. preeclampsia/severe) (2) Eclampsia : the signs and symptoms of pre-eclampsia withconvulsion .(= 3. eclampsia)Etiology :1. Utero-placental ischaemia :Abnormal development of the placental bed vessels / shallowtrophoblast invision in spiral arteries / acute arterosis /2. Endothelial cell activation/dysfunction:Cytotoxic factors : oxygen free raicals /lipid peroxidation / very lowdensity lipoprotein(VLDL)

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