IN The Name of God. Negin Rezavand Associate Professor Of OB &GYN KUMS.
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Transcript of IN The Name of God. Negin Rezavand Associate Professor Of OB &GYN KUMS.
IN The Name of God
PREECLAMPCIANegin Rezavand
Associate Professor Of
OB &GYNKUMS
Management of preeclampcia
Severity Gestational age BP
Treatment Goal Less trauma for mother and
baby Healthy mother Well baby
Mild preeclampcia Hospitalization 2-3 day Control of BP Weekly or 3-4 days visit ↓physical activity Diet (protein-cal.) No limited use of Na ,K
Hospitalization Control of BP q4h Assess for proteinuria LFT BUN , Cr q48h PT,PTT, uric acid , LDH
Mild preeclampcia
Waiting for begining NVD or ripening Cx
Sever preeclampcia Control of BP Prophylaxis for eclampcia Delivery
Delivery Ripening Cx- Induction –C/S Delay in delivery Except : -Heelp Syn -IUGR
Glucocorticoid Befor delivery for maturation Heelp syn Thrombocytopenia
When we can’t delay in delivery
Poor sign Eclampcia Sever Hypertension ↓ o2 Saturation Oliguria < 500 cc/24h Dyspnea Pulmonary edema PLT < 100000 1μlit
Decolman Fetal distress PROM IUGR Oligohydraminous < 5 BPP≤ 4 Dopler reverse IUFD
Mgso4 Kidney clearance (Cr-serum) Control with
(RR,U/O,Reflex.p) Adequate serum level
4-7mEq/lit
Toxicology Mgso4 Serum level 10meq/lit →↓Reflex .p Serum level>10meq/lit →respiratory
depression Serum level ≥12meq/lit
→respiratory Arrest Management
MgSo4 administration protocol
Effect of Mgso4 on uterine Effect of mgso4 on
Neonate
Serum Therapy
Ringer lactate 60-125cc/h
Which Anesthesia is choice?
GA Spinal
Epidural
Long Term outcome
What happen in next pregnancy?
Late Complication
Chronic Hypertension Cardiovascular disorder CVA Thromboemboli Mortality Renal failure -Renal disease Neurologic
Prevention of Preeclampcia
Diet & Supplements A→ Low salt diet B →Calcium C →Fish oil
Drugs A →Diuretics B →Anti Hypertensives
Anti OxidantsA →Vit CB →Vit E
Anti thrombotic
A →Low dose Aspirin B →Aspirin+Dipyridamol C →Aspirin +Heparin
THANKS FOR YOUR ATTENTION