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- National High Blood Pressure Education Program
- Working Group Report On High
Blood Pressure In Pregnancy
- 2000 Update
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- Ray W. Gifford, Jr., M.D., Chair
- Phyllis A. August, M.D. Donald McNellis, M.D.
- Gary Cunningham, M.D. James M. Roberts, M.D.
- Lee A. Green, M.D., M.P.H. Baha M. Sibai, M.D.
- Marshall D. Lindheimer, M.D. Sandra J. Taler, M.D.
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- Preeclampsia
- Eclampsia
- Chronic hypertension
- Preeclampsia superimposed upon chronic hypertension
- Gestational hypertension (only during pregnancy)
- Transient hypertension (only after pregnancy)
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- Occurs after 20th week (earlier with trophoblastic disease)
- Increased BP (gestational BP elevation) with proteinuria
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- Most severe form of PE
- Seizures develop
- Coma may develop
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- Acts as CNS depressant
- Raises seizure threshold
- May decrease blood pressure
- May decrease contractions
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- Reflexes
- Respirations
- Urine Output
- Blood levels
- Calcium is antagonist
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- Hemolysis
- Elevated Liver enzymes
- Low Platelet count
- MULTIPLE-ORGAN-FAILURE
- Stabilize and Deliver
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- Blood Pressure 1-4 hours (if on Mag, more frequent)
- Pulse, Respirations
- Urinary Output (>30ml/h)
- Urine Protein every hour
- Pulmonary Status
- Deep Tendon Reflexes
- Clonus
- H/A
- Visual Disturbances
- *Epigastric Pain (OMINOUS)*
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- Encourage good placental profusion
- Push in the side-lying position (if possible)
- Encourage family member attendance
- Keep informed!!!
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- Woman can explain P/E and its implications
- No eclamptic seizures
- Recognize early signs of increasing severity and get help
- Healthy Newborn J
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- Defined as hypertension
- diagnosed:
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- Goal- Prevent PE and ensure growth
- Daily Rest
- Monitor B/P @ Home
- Medication adherence
- Diet
- Kick counts
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- Diagnosis of gestational hypertension:
- Detected for first time after midpregnancy
- No proteinuria
- Only until a more specific diagnosis can be assigned postpartum
- If preeclampsia does not develop and
- BP returns to normal by 12 weeks postpartum, diagnosis is transient
hypertension.
- BP remains high postpartum, diagnosis is
chronic hypertension.
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- Hypertension and no proteinuria < 20 weeks:
- New-onset proteinuria
- Hypertension and proteinuria < 20 weeks:
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