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.
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IN The Name of God
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PREECLAMPCIANegin Rezavand
Associate Professor Of
OB &GYNKUMS
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Management of preeclampcia
Severity Gestational age BP
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Treatment Goal Less trauma for mother and
baby Healthy mother Well baby
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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
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Hospitalization Control of BP q4h Assess for proteinuria LFT BUN , Cr q48h PT,PTT, uric acid , LDH
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Mild preeclampcia
Waiting for begining NVD or ripening Cx
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Sever preeclampcia Control of BP Prophylaxis for eclampcia Delivery
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Delivery Ripening Cx- Induction –C/S Delay in delivery Except : -Heelp Syn -IUGR
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Glucocorticoid Befor delivery for maturation Heelp syn Thrombocytopenia
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When we can’t delay in delivery
Poor sign Eclampcia Sever Hypertension ↓ o2 Saturation Oliguria < 500 cc/24h Dyspnea Pulmonary edema PLT < 100000 1μlit
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Decolman Fetal distress PROM IUGR Oligohydraminous < 5 BPP≤ 4 Dopler reverse IUFD
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Mgso4 Kidney clearance (Cr-serum) Control with
(RR,U/O,Reflex.p) Adequate serum level
4-7mEq/lit
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Toxicology Mgso4 Serum level 10meq/lit →↓Reflex .p Serum level>10meq/lit →respiratory
depression Serum level ≥12meq/lit
→respiratory Arrest Management
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MgSo4 administration protocol
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Effect of Mgso4 on uterine Effect of mgso4 on
Neonate
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Serum Therapy
Ringer lactate 60-125cc/h
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Which Anesthesia is choice?
GA Spinal
Epidural
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Long Term outcome
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What happen in next pregnancy?
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Late Complication
Chronic Hypertension Cardiovascular disorder CVA Thromboemboli Mortality Renal failure -Renal disease Neurologic
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Prevention of Preeclampcia
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Diet & Supplements A→ Low salt diet B →Calcium C →Fish oil
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Drugs A →Diuretics B →Anti Hypertensives
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Anti OxidantsA →Vit CB →Vit E
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Anti thrombotic
A →Low dose Aspirin B →Aspirin+Dipyridamol C →Aspirin +Heparin
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THANKS FOR YOUR ATTENTION