Preeclampsia.doc

Preeclampsia.doc - Marlene Sosa Unit 4 Preeclampsia New...

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Marlene Sosa Unit 4 Preeclampsia New onset of hypertension (BP >140/90 mmHg) and proteinuria (>300mg/24h) after 20 weeks of gestation. Probable edema. 5-7% of all pregnancies End result: vasospasm and endothelial injury in multiple organs Etiology: Precise etiology unknown. Theories: 1. Imbalance between thromboxane A 2 (vasoconstrictor and platelet aggregator) and prostacyclin (vasodilator) 2. Abnormal trophoblastic invasion of spiral arteries 3. Increased sensitivity to angiotensin II by the muscular walls of the arteries 4. Excess circulating soluble fms-like tyrosine kinase 1 (SFlT-1), which binds placental growth factor (PlGF) and vascular endothelial growth factor (VEGF), may have a pathogenic role
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Risk Factors: Nulliparity Family history of preeclampsia Obesity Multifetal gestation Preeclampsia in previous pregnancy Poor outcome in previous pregnancy Intrauterine growth retardation, abruptio, fetal death Preexisting medical—genetic conditions ● ● Chronic hypertension ● ● Renal disease ● ● Type 1 (insulin-dependent) diabetes mellitus ● ● Thrombophilias P r o t e i n C , S , a n t i t h r o m b i n d e Antiphospholipid antibody syndrome
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f i c i e n c y Factor V Leiden Treatment: Avoid ACE inhibitors as in any other pregnancy The definitive treatment for preeclampsia is delivery of the fetus and placenta. Non pharmacologic treatment:
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Preeclampsia.doc - Marlene Sosa Unit 4 Preeclampsia New...

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