1)Mild > Mother: bed rest in left lateral position and delivery Daily urine dipstick,24-hour urine protein test twice weekly V Blood pressure monitoring,every 4 hours Weigh daily Liver and renal function monitor weekly
1) Mild ➢ Mother: ✓ bed rest in left lateral position and delivery ✓ Daily urine dipstick, 24-hour urine protein test twice weekly ✓ Blood pressure monitoring, every 4 hours ✓ Weigh daily ✓ Liver and renal function monitor weekly
Assessments of gestational age and fetal weight by ultrasonography every 2 weeks Diastolic pressure >100mmHg,gestational age <30 weeks,use antihypertensive medications Sedatives-controversy,interfere with fetal heart rate testing
✓ Assessments of gestational age and fetal weight by ultrasonography every 2 weeks ✓ Diastolic pressure >100mmHg, gestational age 30 weeks, use antihypertensive medications ✓ Sedatives-controversy, interfere with fetal heart rate testing
Fetus NST and ultrasound assessment of amnionic fluid twice-weekly,nonreactive NST OCT Amniocentesis to determine the lecithin: sphingomyelin ratio 2,not frequently used Corticosteroids:accelerate fetal lung maturity, dexamethasone 10mg iv or im gd x 2 days or 6mg bid x 2 days (betamethasone)
➢ Fetus ✓ NST and ultrasound assessment of amnionic fluid twice-weekly, nonreactive NST OCT ✓ Amniocentesis to determine the lecithin: sphingomyelin ratio > 2, not frequently used ✓ Corticosteroids: accelerate fetal lung maturity, dexamethasone 10mg iv or im qd 2 days or 6mg bid 2 days (betamethasone)
2) Severe > The goals of management Prevention of convulsions Control of blood pressure Initiation of delivery-the definitive mode of therapy,gestational age >28 weeks > Principle: Anticonvulsion,antihypertension,sedative, fluid expansion,diuresis Anticonvulsant and antihypertension as eclampsia
2) Severe ➢ The goals of management ✓ Prevention of convulsions ✓ Control of blood pressure ✓ Initiation of delivery-the definitive mode of therapy, gestational age >28 weeks ➢ Principle: ✓ Anticonvulsion, antihypertension, sedative, fluid expansion, diuresis ➢ Anticonvulsant and antihypertension as eclampsia
7.Complication Mother Abruptio placenta,eclampsia,HELLP (hemolysis. elevated liver enzymes,and low platelets) syndrome,DIC Fetus Uteroplacental insufficiency, intrapartum fetal distress or stillbirth,SGA fetus,early delivery
7.Complication ➢ Mother ✓Abruptio placenta, eclampsia, HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome, DIC ➢ Fetus ✓Uteroplacental insufficiency, intrapartum fetal distress or stillbirth, SGA fetus, early delivery