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Prevention

Prevention. BMI and Diet. Augmented placental production of leptin, adinopectin, TAG, and inflammation BMI>30 increases risk of: Preeclampsia Gestational diabetes Fetal macrosomia. Low Dose Aspirin. Based on a functional imbalance between vasodilator and vasoconstrictor eicosanoids.

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Prevention

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  1. Prevention

  2. BMI and Diet • Augmented placental production of leptin, adinopectin, TAG, and inflammation • BMI>30 increases risk of: • Preeclampsia • Gestational diabetes • Fetal macrosomia

  3. Low Dose Aspirin • Based on a functional imbalance between vasodilator and vasoconstrictor eicosanoids. • TXL-A2 increased and PGI levels decreased • Aspirin- inhibits TX-A2 while PGI can be resynthesized from the endothelium.

  4. Low Dose Aspirin • Can be given provided that: • Have identified risk based on previous history of hypertension, adverse obstetric outcomes, MAP or roll over tests, abnormal doppler waveforms or angiotensin sensitivity tests • No history of aspirin allergy or hypersensitivity • Started on 2nd trimester • Doses lept at 60-80 mg/day • Platelet and coagulation profiles are monitored. • Fetal DuctusArteriosus and urine production/AF volume are monitored.

  5. High Dose Calcium: 2 gram/day High dose Ca (-) PTH Intracellular Ca Smooth muscle relaxation Response to pressor stimuli

  6. High Dose Calcium: 2 gram/day • Ca supplement: -higher level of Ca excretion - increased levels of serum Mg -smooth muscle relaxation in BV -Control of HPN

  7. Anti-Oxidant Therapy • Not recommended

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