Gestational hypertension

Introduction Hypertension in pregnancy (referred to as pregnancy-induced hypertension) is a unique and common disease in pregnant women. It is characterized by hypertension, edema, proteinuria, convulsions, coma, heart and kidney failure, and even maternal and child death. The main lesion is systemic vasospasm, and the result of contracture results in a decrease in blood. Pregnancy-induced hypertension syndrome is classified into mild, moderate, and severe according to severity. Severe pregnancy-induced hypertension syndrome is also called pre-eclampsia and eclampsia. Preeclampsia is convulsion on the basis of hypertension.

Cause

Related to the following factors:

1. First-time pregnant women aged 20 or > 35 years old.

2. Ethnic differences, such as African Americans or Hispanics are higher than whites.

3. Family genetic factors family has a history of hypertension, the mother of pregnant women has a history of PIH, or sisters of eclampsia, daughter daughter-in-law.

4. Have a history of hypertension, nephritis, diabetes and other medical history.

5. Malnutrition anemia, hypoproteinemia.

6. Body weight index >0.24.

7. The spirit is too tight or the work intensity is high.

8. Too much amniotic fluid, twins, and giant moles.

an examination

Related inspection

Electrocardiogram, blood pressure, oxygen partial pressure, routine urinary amygdalin

Normal people's blood pressure has a certain fluctuation range under different physiological conditions. When anxiety, nervousness, stress state or physical activity, blood pressure can be increased. In addition, the systolic blood pressure increases with age, so the boundary between hypertension and normal blood pressure is not easy to divide. In 1979, China revised blood pressure measurement methods and diagnostic criteria for hypertension as follows:

1. After 15 minutes of rest, take the sitting position and measure the blood pressure of the right arm. It should be measured several times until the blood pressure value is relatively stable. The diastolic pressure is based on the disappearance of the sound. If the sound does not disappear, the value at the time of the change is used. One hour apart on the same day, or verified again every other day.

2. Where systolic blood pressure 21.2kPa (160mmHg) and / or diastolic blood pressure 12.6kPa (95mmHg), can be confirmed by verification. Blood pressure 18.7 ~ 21.2 / 12 ~ 12.6kPa (140 ~ 160 / 90 ~ 95mmHg) for clinical hypertension.

3. In the past, there was a history of hypertension. If you have not been treated for more than 3 months, the blood pressure is normal. It is not classified as high blood pressure. If the blood pressure is normal, the blood pressure should be diagnosed as high blood pressure.

Women of childbearing age suffer from the first stage of hypertension, vascular complications are rare, and the fundus, electrocardiogram, heart and kidney function tests are often abnormal, so the diagnosis must be based on elevated arterial pressure. The first visit, such as in the second trimester, due to peripheral vasodilation, hemodilution, and placental formation of arteriovenous shorts, can reduce systolic blood pressure by 2.7 kPa (20 mmHg) in 40% of patients, complicating the diagnosis. It is difficult to identify symptomatic hypertension caused by chronic glomerulonephritis or chronic pyelonephritis, or kidney disease caused by essential hypertension, when there is renal damage in the first visit.

Differential diagnosis

Diagnosis is not difficult based on medical history and typical clinical manifestations. However, it is more difficult to estimate the condition and identify some diseases with similar clinical manifestations. Therefore, it is necessary to comprehensively analyze from various aspects such as medical history, predisposing factors, physical examination and auxiliary examination, in order to make a correct diagnosis. Diagnosis includes severity, classification, and complications, in order to develop a correct approach.

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