4.Clinical findings and diagnosis Edema:nondependent edema of the hands and face,rising from bed in the morning,from ankle upward,pitting,weight gain>0.9kg/w Hypertension:the most important, >140/90mmHg,often increased during sleep, 2:00AM,diastolic pressure is more prognostic sign,30/15mmHg not the criterion, appear two times,interval is 6 hours
4.Clinical findings and diagnosis • Edema: nondependent edema of the hands and face, rising from bed in the morning, from ankle upward, pitting, weight gain>0.9kg/w • Hypertension: the most important, >140/90mmHg, often increased during sleep, 2:00AM, diastolic pressure is more prognostic sign, 30/15mmHg not the criterion, appear two times, interval is 6 hours
Proteinuria:>300mg/24h,last sign,indicator of fetal jeopardy,perinatal mortality from minimal or absent to 10g/24h,to +++ Differing clinical picture:liver disfunction, headache,epigastric pain,visual disturbance, abruptio placenta,anasarca,ascites et al
• Proteinuria: >300mg/24h, last sign, indicator of fetal jeopardy, perinatal mortality from minimal or absent to 10g/24h, + to ++++ • Differing clinical picture: liver disfunction, headache, epigastric pain, visual disturbance, abruptio placenta, anasarca, ascites et al
Lab findings: hemoglobin,hematocrit elevated, thrombocytopenia coagulation factors ALT,AST,ALP,LDH increased,Uric acid,serum creatinine,blood urea nitrogen 1 glucose and electrolytes is normal Urinalysis,proteinuria(+)300mg/24h,(++++ 5g/24h,test every two day,occasional hyaline casts Eyeground exam:retinal arteriolar vasospasm, exudation,edema,hemorrhage,detachment of retina,ratio of V:A diameter from 3:2 to 2:1
• Lab findings: – hemoglobin, hematocrit elevated, thrombocytopenia coagulation factors – ALT, AST, ALP, LDH increased, Uric acid, serum creatinine, blood urea nitrogen glucose and electrolytes is normal – Urinalysis, proteinuria(+) 300mg/24h, (++++) 5g/24h, test every two day, occasional hyaline casts – Eyeground exam: retinal arteriolar vasospasm, exudation, edema, hemorrhage, detachment of retina, ratio of V: A diameter from 3:2 to 2:1
5.Classification Mild:140/100mmHg <160/110 mmHg Severe 1. >160/110mmHg 2. Proteinuria >5g/24h or ++to +++on dipstick testing 3. Serum creatinine increased (>12mg/L) 4. Cerebral or visual disturbance 5. Epigastric pain 6. Liver enzymes elevated 7. Thrombocytopenia PLT <100,000/mm3) 8. Retinal hemorrhage,exudates or papilledema 9. Pulmonary edema
5.Classification • Mild: > 140/100mmHg <160/110 mmHg • Severe : 1. >160/110 mmHg 2. Proteinuria >5g/24h or +++ to ++++ on dipstick testing 3. Serum creatinine increased (>12mg/L) 4. Cerebral or visual disturbance 5. Epigastric pain 6. Liver enzymes elevated 7. Thrombocytopenia ( PLT <100,000/mm3 ) 8. Retinal hemorrhage, exudates or papilledema 9. Pulmonary edema
6.Treatments basic management objectives are (1)Termination of the pregnancy with the least possible trauma to mother and fetus (2)Birth of an infant who thrives (3) Complete restoration of the health of the mother
6.Treatments • basic management objectives are (1) Termination of the pregnancy with the least possible trauma to mother and fetus (2) Birth of an infant who thrives (3) Complete restoration of the health of the mother