16) Hypertensive disorders of pregnancy 9/1/2022

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-Chronic hypertension+ supraimppose
-Gestational hypertension after 20 weeks without protienurrua.
-Preeclampsia after 20weeks and protienurrua with multiorgan failure and we terminate.
-Mild 140/90 with no symptoms or laboratory changed
- 160/110 with or without complications .
If Complication we terminate directly.
Risks : renal disorders or primgravida or high STG or presence of vesicular mole.
Pathophysiology of *preeclampsia* related to placenta as its fully developed at 20 weeks. Since trophoblasts affect the muscle walls of vascular resistance and lower it and leads to vasodilation and increase placenta perfusion. BUT IN HYPERTENSION THERE IS FAILURE OF invasion of trophoblasts and less placenta perfusion and it also it release toxic inflammatory mediators in the womens body ALL organs as it damage the vascular endothelium and can cause increase permeability and leading fibrousis and accumulation of clotting factors forming hematomas.
Clinical signs: bp, weight gain due edema, protienurue.
Symptomes WILL BE AFTER 20 WEEKS AND DURING FIRST TRIMESTER: edema, headache, epigastric pain, RIGHT hypogastric pain, projectile vomitting, perception of fetal movements. Vaginal bleeding due placenta rupture.
COMPLICATIONS: Clamspia, DIC and check fr coagulation tests, HELLP SYNDROME by low platelets counts.
-CBC: low hemoglobin due RBC distriction, high hematocrite, low platelets, ALT, AST, CREATININE.
-URINE: high AC ration which albumin increase and creatinine low to detect early preeclampsia before any organ dysfunction.
-MİLD KEEP WİTH CLOSE OBSERVATİON.
-Sever uncomplicated TERMİNATİON if after 36 weeks. İf before, we control bp and fetal observation till 36 weeks WİTH ANTİHYPERTENSİVE MEDİCATİONS to control cerebral hemorrhage just, not to lower bp because the fetal is adapted to have more perfusion by this high bp.
WİTH STEROİDS AT 34/36WEEKS FOR RESPİRATORY MATURATİON.
MEDİCATİONS BP: alphademethialoma and aldomide. Alpha beta blockers( labetalol) if not controlled hydrolizine İV in terminate sergery ,magnisium sulfate to prevent antipoton eclamsia and posportium eclamsia before time of termination within 24 hours and specially after termination to prevent the postpartum eclamsia and we give loading dose and we increase every 4 hours for 24 hours and make sure she dont have planterlar refluxes and any respiratory depression or oligourea , calcium channel blockers like nifidine in preterm labor
-Sever complicated: control bp and imediate termination.
Ultrasound: check amniotic fluid for olgahardoise and fetal growth.
Doppler to asses the resistance.
Fundus examination.
CT brain after termination in sever
Low dose aspirin for chronic hypertension patients till 4 weeks before termination
Calcium and vitamin D supplements

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management of preeclampsia :- 57:00

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ممكن تفيدوني
لماذا لم تشرح chronic HTN of pregnancy

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عاشت ايدج دكتورة

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Perfect 🙏🏻🤍

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روعه 💕💕

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لو سمحتي دكتورة وين شرح ال eclampsia ؟

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قمة الابداع طالبك من العراق

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الsheet اللي بيتكلموا عليها اجيبها منبن؟

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شرح رائع شكرا لحضرتك
مافيش اسئله PDF عن المحاضره

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❤تسلمى

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Thanks

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الاقي فين شرح ال eclampsia?🌸

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وجدتي شرح ال eclampsia ؟

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good

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Arabic

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