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Pregnancy related Illnesses

Pregnancy related Illnesses. Preeclampsia HTN , proteinuria & edema Eclampsia  Preeclampsia + Sz HELLP  Hemolysis , elevated LFT & Low plt count TTP  low plt , MAHA , renal & CNS dysfunction. Severe Preeclampsia.

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Pregnancy related Illnesses

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  1. Pregnancy related Illnesses • Preeclampsia HTN , proteinuria & edema • Eclampsia  Preeclampsia + Sz • HELLP  Hemolysis , elevated LFT & Low plt count • TTP low plt , MAHA , renal & CNS dysfunction

  2. Severe Preeclampsia • New onset proteinuric HTN & at least one of the following: • CNS Symptoms • Symptoms of liver capsule distention • Hepatocellular injury: Serum ALT & AST> 2 N • Severe BP: SBP160 or DBP110 mm Hg on two occasions at least six hours apart

  3. Severe Preeclampsia • Thrombocytopenia:< 100,000 • Proteinuria:> 5gm/24 hours Oliguria <500 mL/24h • Pulmonary edema • Cerebrovascular accident • Severe fetal growth restriction

  4. Management Lines • Early diagnosis & Close observation • Early delivery • Corticosteroid  HELLP faster recovery & less relapse Hiemel Eur Jr Obst & Gyne 2006 • BP control  hydralazine, Labetalol, Nifidipine ACEI & ARB are contraindicated

  5. Management Lines • Sz prevention MgSO4 superior to phenytoin ( 0 Vs 9 cases out of 2000 pt) Lucas NEJM 1995 • Sz Rx MgSO4is better than phenytoin & diazepam (1500 pt)  better termination & less recurrence Collaborative Eclampsia Trial. Lancet 1995

  6. Management Lines • IVIG & Plasmapherisis TTP & non resolving HELLP cases (case reports no RCT ) • Surgery HELLP related liver rupture

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