妊娠期高血压疾病.ppt

该【妊娠期高血压疾病 】是由【junjun2875】上传分享，文档一共【49】页，该文档可以免费在线阅读，需要了解更多关于【妊娠期高血压疾病 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。Hypertensive Disordersin Pregnancy
Teng YinCheng
Shanghai Jiaotong University Affiliated Sixth People's Hospital, Dept of Obs & Gyn
单击此处添加正文，文字是您思想的提炼，
请尽量言简意赅的阐述观点。
演讲人姓名
Contents
Etiology & Pathogenesis
01
Clinical features
02
Physiopathology
03
Classification
04
Diagnosis
05
Management
06
Incidence
Commonly about 5 percent
Markedly influenced by parity
Related to race and ethnicity—A genetic predisposition
Main Risk Factors
Nulliparous (初产妇)
Multiple pregnancy
History of chronic hypertension
Maternal age over 35 years
Obesity
Lower socioeconomic status
…
Incidence and Risk Factors
Roberts, J. M. et al. Hypertension 2005;46:1243-1249
Used with permission
单击此处添加小标题
stage model of the pathophysiology of preeclampsia
单击此处添加小标题
Stage 2 develops in some, but not all women with stage 1
单击此处添加小标题
Etiology and Pathogenesis
单击此处添加小标题
Normal:
vessel remodeling (血管重铸) of the decidua and myometrium
transforming into large-capacitance, low-resistance vessels
Faulty Placentation (胎盘形成不良)---Stage I
Etiology and Pathogenesis
Preeclampsia:
incomplete remodeling
limited to the superficial decidua
myometrial segments remain narrow
Etiology and Pathogenesis
Incomplete vessel remodeling → Reduced placental perfusion → placenta ischemia（缺血） and hypoxemia（缺氧） → Oxidative distress → Endothelia dysfunction → affected production of Nitric Oxide/ Prostaglandins（前列腺素）
Oxidative distress （氧化应激）
01
Immune system dysfunction
Genetic predisposition
Malnutrition
Other factors
02
Genetic factors
immunological factors
Maternal vascular disease
Environmental factors
Reduced uteroplacental perfusion
Faulty placentation
Endothelial activation
Systemic vascular dysfunction
Capillary leak
vasospasm
Hypertension
Cerebral edema (eclampsia)
Edema
Proteinuria
Coagulation abnormalities (HELLP)
Fetal growth restriction (FGR)
Pathogenesis of preeclampsia
Basic change:
System Vasospasm （全身小动脉痉挛）
Hemorrhage, edema, hyperemia充血, thrombosis
Visual disturbances: blurred vision, blindness, retinal detachment （视网膜脱落）
Reduced renal perfusion and glomerular filtration肾小球滤过率
Proteinuria; increased uric acid; oliguria
Ischemia, edema → elevated serum transaminases (ALT, AST, AKP..); jaundice （黄疸）
Subcapsular hematoma(肝包膜下出血) or hepatic rupture
Physiopathology ------ sgage II