tailieunhanh - HYPERTENSIVE DISORDERS DURING PREGNANCY

The hypertensive disorders of pregnancy have been variously classified without consensus being achieved as to a lasting classification. A practical classification may be achieved by modification of the system proposed by the American Committee on Maternal Welfare (1985). I. Pregnancy Induced Hypertension (Preeclampsia-eclampsia, toxemia, EPH, and gestosis) | HYPERTENSIVE DISORDERS DURING PREGNANCY CLASSIFICATION The hypertensive disorders of pregnancy have been variously classified without consensus being achieved as to a lasting classification. A practical classification may be achieved by modification of the system proposed by the American Committee on Maternal Welfare 1985 . I. Pregnancy Induced Hypertension Preeclampsia-eclampsia toxemia EPH and gestosis Gestational hypertension Preeclampsia 1. Mild 2. Severe HELLP Syndrome Eclampsia II. Chronic hypertension Primary essential idiopathic Secondary to some known cause 1. Renal . parenchymal glomerulonephritis chronic pyelonephritis interstitial nephritis and polycystic kidney disease renovascular nephritis 2. Adrenal cortical-Cushing s disease hyperaldosteronism medullary-pheochromocytoma 3. Other coarctation of the aorta thyrotoxicosis etc. III. Chronic hypertension with superimposed preeclampsia IV. Transient atypical undiagnosed hypertension a nebulous group of patients who develop hypertension in labor or immediately postpartum Modifications 379 Copyright 2001 The McGraw-Hill Companies. Click Here for Terms ofUse. BENSON PERNOLL S 380 HANDBOOK OF OBSTETRICS AND GYNECOLOGY PREGNANCY-INDUCED HYPERTENSION DEFINITIONS INCIDENCE ETIOLOGY AND IMPORTANCE Preeclampsia-eclampsia a multisystem disorder of unknown etiology peculiar to pregnant women remains a major contributor to maternal and perinatal morbidity and mortality both in developing as well as industrialized nations. Currently it is not possible to predict who will acquire the processes. There are no strategies for prevention. This group of conditions are progressive but with variable presentations and rates of progression. Moreover after clinical symptoms have occurred there are only symptomatic therapeutic options. One or another of the hypertensive disorders will complicate approximately 10 of pregnancies. The mildest form of the process is gestational hypertension which consists of systolic blood pressure

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