Мавзу: Хомиладорликдаги ва тугрукдаги гипертензив холатлар

P – Хомиладор III, 36-37 хафта. Оғир преэклампсия. Чап ёнига ётқизиш лозим

I – Чап ёнига

C – Ўнг ёнига

O – Оқибат

Шошилинч ёрдамда Оғир преэклампсия билан беморнинг холати кандай бўлади?

5. Хомиладор III, 36-37 хафта. Оғир преэклампсия. Шошилинч медикаментоз ёрдам?

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  P – Хомиладор III, 36-37 хафта. Оғир преэклампсия.
  
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  I – magnesia sulfatis 25%
  
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  C – нифедипин, коринфар
  
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  O – оқибати.
  

Ташхис: Асосий: Хомиладорлик III, 36-37 хафта. Оғир преэклампсия. Асоратлари: Сурункали ДВС-синдром.


Исботланган тиббиёт сайтида изланишлар натижалари:
1. PubMed - indexed for MEDLINE The effects of exposure to particulate matter and neighbourhood deprivation on gestational hypertension.
Vinikoor-Imler LC, Gray SC, Edwards SE, Miranda ML.
Elucidation of some of the mechanisms responsible for blood pressure elevation in pregnancy has permitted therapy to be based on more rational principles. The decreased arterial reactivity encountered in normotensive pregnancy is most likely mediated by prostaglandins; preventive therapy using low dose aspirin is an option to prevent development of proteinuria in pre-existing hypertension and provide prophylaxis against pregnancy-induced hypertension. 2. Antihypertensive therapy utilizing sympathetic inhibition with either methyldopa or alpha- and beta-adrenoceptor blockade yields the most promising results. Vasodilation with hydralazine, calcium entry blockers (nifedipine), intravenous labetalol or diazoxide is primarily used in severely hypertensive patients. The use of orally administered nifedipine in severely hypertensive women is associated with encouraging results. 3. It is clear that women with blood pressure levels greater than 170/110 mm Hg need antihypertensive therapy for maternal safety; it remains to be proven to what extent foetal growth and welfare can be improved in women with diastolic pressure levels 85-110 mm Hg when adrenoceptor blocking agents are used for blood pressure control. Initial studies are suggestive of improved foetal growth, prevention of proteinuria and the respiratory distress syndrome but more long-term controlled studies are required. 4. In a recent study, at our institution, of foetal growth during long term antihypertensive therapy, treatment with pindolol yielded better foetal growth than therapy with atenolol. It is as yet unclear whether the ISA or beta 2-mediated vasodilation associated with pindolol was responsible for the improved foetal growth. Further controlled studies are indicated in hypertension in pregnancy to confirm the suggested benefits of beta-adrenoceptor blocker therapy.
Дальнейшее қонтролируемое исследование указало, что при гипертензии во время беременности для подтверждения предпологаемых преимущественным выбором явлются бета-адреноблокаторы.
2 Screening at 11-13+6 weeks' gestation.
Sonek JD, Nicolaides KH, Janku
Department of Maternal Fetal Medicine, Wright State University, Dayton, Ohio, USA. [e-mail]
Ultrasound examination of the conceptus and the uterine blood supply between 11 and 13 weeks' gestation provides important information about the state of the pregnancy at that point in time and about its future progress. Nuchal translucency measurement in conjunction with maternal serum markers (free-beta-human chorionic gonadotropin andpregnancy-associated plasma protein-A), has been shown to be a highly effective method for screening for aneuploidy. This is further improved by the addition of other more recently discovered first trimester ultrasound markers resulting in detection rates that exceed 90% with a false positive rate of 2.5%. Many fetal structural anomalies can be detected at this gestational age. Recently described first trimester evaluation of the posterior brain (intracranial translucency (IT)) provides an effective screening tool for the presence of open neural tube defects. Doppler measurement of the pulsatility index in the uterinearteries in conjunction with maternal history and examination as well as maternal serum biochemistries helps to accurately establish the risk of developing preeclampsia.
Доплерометрические изменения пульсации индекса в маточной артерии в сочетании с материнским анамнезом и исследования, а также исследования материнской сыворотки помогают точно установить риск развития преэклампсии.

4.