妊高症英文

The fetus is a semi-allograft to the mother. Immune interaction between decidual leukocytes and invading cytotrophoblast cells is essential for normal trophoblast invasion and development. Immune maladaptation may cause shallow invasion of spiral arteries by endovascular cytotrophoblast cells and endothelial cell dysfunction mediated by an increased decidual release of cytokines, proteolytic enzymes, and free radical species.
Mild preeclampsia is characterized by a systolic BP greater than 140 mm Hg or a diastolic BP greater than 90 mm Hg in a pregnant patient with minimal proteinuria((>300mg/d )and pathologic edema.
病
例
张平，女，36岁，以“停经九个月，胎动五个 月，双下肢浮肿两周，头晕眼花一小时。”为主诉 入院。早孕反应及胎动如期出现，两周前无明显诱 因双下肢浮肿，休息后无好转。一小时前出现头晕 眼花。既往无高血压，慢性肾炎病史。
查体：T36.7℃，P78次/分，BP175/110mmHg, 心肺听诊无异常，腹膨隆，足月腹型，LOA，浮肿 +++。
preeclampsia is a disease of first pregnancies. The protective effect of multiparity, however, is lost with change of partner. Also, exposure to semen provides protection against developing preeclampsia. Analogous to altered paternity, artificial donor insemination and oocyte donation are reported to result in a substantial increase of preeclampsia. Thus, epidemiologic studies strongly suggest that immune maladaptation is involved in the etiology of preeclampsia.
Risk factors
extremes of maternal age, primigravida, multiple gestations, molar pregnancy, diabetes mellitus (DM), renal disease, connective tissue disease, vascular disease, prior history of preeclampsia or eclampsia, and family history of preeclampsia or eclampsia.
Normal placental development involves progressive loss of the musculoelastic tissue in the spiral arteries that feed the vessels of the intervillous spaces, which results in uterine blood flow increases of nearly 25% during the first trimester. In women destined to develop preeclampsia, this physiologic dilatation of the spiral arteries does not occur because the placental trophoblast cells do not invade the spiral arteries. In severe cases, other pathologic changes also occur. Accumulation of fat-laden macrophages with fibrinoid necrosis (ie, acute atherosis), disruption of the basement membranes, platelet deposition, mural thrombi, and proliferation of intimal and smooth muscle cells all decrease the luminal diameter.
Preeclampsia is defined as the combination of high blood pressure (hypertension), swelling (edema), and protein in the urine (albuminuria, proteinuria) developing after the 20th week of pregnancy.
Severe preeclampsia A systolic BP greater than 160 mm Hg or a diastolic BP greater than 110 mm Hg with significant proteinuria (>5.0 g/d) and evidence of end-organ damage. Serum creatinine>106µmol/L, Platelet:<100x109/L elevated LDH, ALT or AST
Genetic gactor
Development of preeclampsia-eclampsia may be based on a single recessive gene or a dominant gene with incomplete penetrance. Penetrance may be dependent on fetal genotype. The possibility of genetic imprinting should be considered in future genetic investigations of preeclampsia.
实验室检查：血常规示P百度文库258G/L，HGB108g / L，HCT0.45。尿常规示蛋白+++。
辅助检查：B超示BPD9.0cm，FL7.2cm，胎盘钙 化Ⅱ级。NST有反应型。
Hypertensive disorder complicating pregnancy
妊娠期高血压疾病
Preeclampsia