“””” “” Hypertension is far from you”
On the evening of May 12, Ms. Liu (pseudonym), who was 31 weeks pregnant, suddenly twitched at home and fell to the ground with unclear consciousness. The family urgently sent her to Changsha Central Hospital (Changsha Central Hospital affiliated to Nanhua University) for inspection.
Improve the CT to indicate the crushing fracture of the upper part of the right humerus and the dislocation of the right shoulder joint. The blood pressure is as high as 190/120mmHg. Considering the possibility of eclampsia, the situation is critical.
Ms. Liu is 33 years old and is a expectant mother of 31 weeks of pregnancy. Because she is pregnant with her first child, her family is very concerned about her and eats very rich every meal.
Ms. Liu’s weight has grown rapidly throughout pregnancy, from 65kg before her pregnancy to 31 weeks of pregnancy has increased to 90kg. Fortunately, the early production inspections are within the normal range.
About a month ago, Ms. Liu’s calf began to have edema and gradually spread to her thighs and abdomen.
"The neighbors said that the advanced edema of pregnant women was normal. After giving birth to a child, she would disappear naturally, and she didn’t care," said Ms. Liu.
Because it is usually good and the early pregnancy and the mid -term are smooth, all indicators are normal during the birth inspection at the end of March, and the edema should not be taken as a matter of time.
On the evening of May 12, Ms. Liu suddenly twitched when she went out and returned home. She fell to the ground, unclear consciousness, and whitening her mouth.Go to the hospital.
"At the time of admission, the patient had a second twist and awareness disorder. We immediately sent her directly to the emergency rescue room for rescue, and immediately improved the relevant examination. It was found that its blood pressure reached 190/120mmHg, the severe depression of the lower limbs, the fetal heartAt about 150 times/minute, the possibility of eclampsia is preliminarily considered, and the respiratory tract is unobstructed. After the magnesium sulfate is continuously pumped into the treatment of anti -spasm and antihypertensive treatment, the patient gradually stops twitching and restores awareness. "
Huang Yizhen, deputy chief physician of the obstetrics and gynecology department of Changsha Central Hospital (Affiliated to Nanhua University), introduced that the regular rules of patients were prompted to urine protein 3+, and blood routine reminded platelet 60*10^9/L (normal value: 125-350*10^9/L), the relevant test results also support this diagnosis, and the CT examination shows that the head of the head has not seen the signs of cerebral hemorrhage.
However, in addition to the high blood pressure, Ms. Liu also merged the right upper limb trauma. The CT prompted the crushing fracture and the right shoulder joint dislocation of the upper part of the right humerus.
"Orthopedics consultation is recommended to treat fractures and dislocation after stability of pregnant women. According to the diagnosis and treatment specifications of hypertension during pregnancy, the pregnancy pregnant women can consider termination of pregnancy after convulsions.Dipping and other complications, mothers and infants will fall into dangerous situations. "
Huang Yizhen introduced that after detailed communication with Ms. Liu and her family members, the obstetrician was performed by a cesarean section.
At 00:20 on May 13th, after a multi -disciplinary cooperation such as obstetrics, anesthesia, and neonatal departments, the operation was very smooth. Ms. Liu gave birth to a baby boy weighing 1700g.
Premature babies transferred to the neonatal department for further treatment. Ms. Liu also transferred to the intensive medical department to observe and treat it closely after surgery. After 1 day, her condition was steadily transferred to the obstetric ward. At present, she has been transferred to the trauma orthopedic and the micro -surgery of the hand and foot.
"The doctor said that the first month ago, the doctor said that it was normal. Why would it become so serious later?" Ms. Liu, who was lying on the hospital bed, was grateful to the hospital for treatment, and still wondered her condition.
Rao Lijuan, director of the obstetrics and gynecology science department, analyzed the reason carefully: "According to the history of the medical history, excessive gain during pregnancy is a high -risk factor, and there have been aura symptoms, such as sudden edema and aggravation, but you have not paid attention.It did not go to the hospital to improve the birth check in time. The progress of hypertension during pregnancy is very rapid, and it may develop very seriously within a few days. Once the condition worsens, it is easy to cause serious complications such as eclampsion, heart failure, cardiovascular and cerebrovascular accidents, etc.","
"Oclamposity is a type of hypertension during pregnancy, and hypertension during pregnancy refers to a set of diseases that coexist with rising pregnancy and blood pressure.Combined chronic hypertension, chronic hypertension concurrent eclampsion. "
Huang Yizhen introduced that hypertension during pregnancy is one of the main reasons for the death of maternal and siege in the world.
Its basic pathological changes are small blood vessel spasm and vascular endothelial damage of the whole body, which can cause reduction of various organs and system damage to the system of various organs and systems, such as cerebral hemorrhage, liver and kidney damage, heart failure, platelet reduction, placenta, placenta, placentaEarly peeling, limited fetal growth, etc., in severe cases endanger mother’s life.
Therefore, it is important to take preventive measures.
High -risk factors of pre -eclampsia include age ≥35 years, BMI (weight index) ≥ 28kg/㎡ before pregnancy, first pregnancy, hypertension genetic factors, hypertension, kidney diseases, diabetes, etc.Take a series of preventive measures.
Including diet guidance, reasonable exercise, aspirin, etc., if there is a pregnancy plan, a pre -pregnancy examination is carried out to evaluate the risk of pregnancy. It is very important to do pre -pregnancy health care.
In addition, there are some early warning information in the early stage of eclampsia, including pathological edema, excessive weight gain, blood pressure on a normal limit, etc. When these are the case, the number of postpartum examinations should be increased to detect hypertension during pregnancy and deal with it in time.
Dr. Huang Yizhen reminds the majority of pregnant women and pregnant mothers to do a good job of pre -pregnancy examination and pre -pregnancy health care. During pregnancy, production inspections should be standardized, their lifestyle and diet should be managed, exercise appropriately, and controlling weight.
Once there is any symptoms of discomfort, seek medical treatment as soon as possible to avoid serious complications such as eclampsia.
(Edit Rainbow. Picture source network, invading deletion)
Hunan Medical Chat Special Author: Changsha Middle Hospital (Changsha Central Hospital affiliated to Nanhua University) Hu Yuan Fu Qing
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