Pregnancy poisoning

Introduction Pregnancy poisoning refers to high blood pressure, edema and proteinuria after 20 weeks of gestation. In severe cases, convulsions and coma can occur. According to the severity of symptoms of pregnant women, the clinical classification is mild pregnancy poisoning, moderate pregnancy poisoning, severe pregnancy poisoning. It is found that pregnancy poisoning should be sent to the hospital for treatment in time to prevent danger. 1. Mild pregnancy poisoning: blood pressure is slightly higher than the basic blood pressure, and may have a urine protein or mild edema. 2. Moderate pregnancy poisoning: There are two or more of hypertension, urinary protein, and edema. 3. Severe pregnancy poisoning: 1 pre-eclamp pain: high blood pressure, edema, urine protein, accompanied by headache, vertigo, chest tightness, nausea, upper abdominal discomfort or vomiting. 2 child pain: on the basis of pre-eclamp pain there are foil and coma. At this time, there may be serious complications such as pulmonary edema, acute heart failure, acute renal insufficiency, cerebrovascular accident, aspiration pneumonia, asphyxia, and fetal death.

Cause

The exact cause of pregnancy poisoning is not yet clear. There are utero-placental ischemia, family genetic factors, immunological theory, hemodynamic changes, and changes in blood viscosity. Uterine placental ischemia may be an important cause of pregnancy poisoning. Because pregnancy poisoning is more common in primipara, multiple pregnancy, polyhydramnios, hydatidiform mole or patients with chronic blood vessels and kidney disease.

an examination

Related inspection

Determination of insulin-c peptide and its release test in routine urine obstetrics

Do a good job prenatal check: blood pressure should be measured early in pregnancy, check urine protein and body weight. Prenatal examinations are carried out on schedule from 5 months of pregnancy, paying close attention to blood pressure, edema and weight changes, and checking urine protein for early detection of pregnancy poisoning and early treatment to prevent the development of the disease.

Pay attention to the past medical history: primipara, twins, polyhydramnios, essential hypertension, chronic nephritis or diabetes patients, due to easy to have pregnancy toxicities, should pay attention.

Differential diagnosis

Liver damage complicated by pregnancy poisoning and pregnancy complicated with viral hepatitis is highly confusing in clinical symptoms. The characteristics of liver damage caused by pregnancy poisoning are:

(1) It is based on signs such as hypertension, edema, and proteinuria in pregnancy toxemia.

(2) Liver parenchymal damage is mainly manifested in markedly decreased albumin, elevated blood ammonia and prolonged prothrombin time, but the changes in alanine aminotransferase and flocculation test are not significant, and are not proportional to the severity of clinical conditions.

(3) The markers of hepatitis A, hepatitis B, hepatitis E antibody immunoglobulin M and other hepatitis viruses are often negative.

(4) Small artery sputum can be seen in the fundus examination.

(5) Liver biopsy showed focal hemorrhage and necrosis around the portal vein, and even large infarction, hepatic subcapsular hemorrhage, edema, extensive fibrin deposition and thrombosis.

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