Preeclampsia

Introduction Pre-eclampsia is defined as an increase in blood (systolic blood pressure 140 mmHg or diastolic blood pressure 90 mmHg) after 20 weeks of gestation, accompanied by proteinuria or edema.

Cause

There are many theories about the pathogenesis of pre-eclampsia, such as imbalance of prostacyclin and thromboxane, immune abnormalities, increased vascular response to vasoactive agents, abnormal placenta, genetic variation of angiotensinogen gene, etc., but No one has been proven, the exact cause is still unclear.

The most important risk factor for pre-eclampsia is the history of pre-eclampsia in a first pregnancy or a previous pregnancy. Pre-eclampsia rarely occurs in prolific women who have had previous illnesses (the father who is not the fetus of this pregnancy is not the same person as before). There is currently no means of predicting pre-existing sputum, and the assessment of risk factors cannot distinguish which women are mild, which women are seriously ill and have multiple organ dysfunction.

Pre-eclampsia can be considered as a result of systemic small vasospasm. Vasospasm causes tissue ischemia, and the function of different affected organs changes.

an examination

Related inspection

Urine specific gravity urine specific gravity 3h test urine sediment urine sediment tubular urine sediment cytology

Pre-eclampsia is usually diagnosed according to the triad of hypertension, proteinuria and edema. Given that edema is a common manifestation of normal pregnancy, it has not been accepted as one of the criteria in recent diagnostic criteria. Identifying the corresponding signs and identifying symptoms is especially important for medical staff who are not the main personnel obstetric care work. Emergency doctors should be aware of the pathophysiological changes and diagnostic criteria of pre-eclampsia, and think of this possibility when encountering a pregnant patient who presents with a seemingly unrelated problem.

Pre-eclamp pain is classified as mild and severe. Mild pre-eclampsia refers to blood pressure measurement at intervals of 6 hours or more, systolic blood pressure 140mmHg or diastolic blood pressure 90mmHg.

Differential diagnosis

Eclampsia is a special manifestation of "pregnancy-induced hypertension syndrome" (pregnancy-induced hypertension) after 20 weeks of gestation, including edema, hypertension, and proteinuria, especially in the most severe and emergency situations in late pregnancy, with convulsions and coma. Characteristic, can be complicated by renal failure, heart failure, pulmonary edema, intracranial hemorrhage, early exfoliation of the placenta. Pre-eclampsia is preceded by convulsions, with symptoms of headache, dizziness, vertigo, upper abdominal discomfort, and nausea on the basis of pregnancy-induced hypertension, indicating the stage of eclampsia.

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