Systolic blood pressure ≥140mmhg and diastolic blood pressure ≥90mmhg first appear after 20 weeks of pregnancy and return to normal within 12 weeks postpartum

Urinary protein (-)

Systolic blood pressure ≥160mmhg and diastolic blood pressure ≥110mmhg are severe gestational hypertension.

After 20 weeks of pregnancy, systolic blood pressure ≥140mmhg and diastolic blood pressure ≥90mmhg are found, accompanied by: urine protein ≥0.3g/24h; urine protein/creatinine ratio ≥0.3; random urine protein ≥ ( )

After 20 weeks of pregnancy, systolic blood pressure ≥140mmhg and diastolic blood pressure ≥90mmhg are found, accompanied by: urine protein ≥0.3g/24h; urine protein/creatinine ratio ≥0.3; random urine protein ≥ ( )

No proteinuria but accompanied by involvement of any of the following organs or systems: heart, lungs, liver, kidneys and other important organs, blood system, digestive system, abnormal changes in the nervous system, placenta-fetal involvement and

Severe

Pregnant women with preeclampsia experience convulsions

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Pregnant women with chronic hypertension have no proteinuria before 20 weeks of pregnancy, but then develop proteinuria ≥0.3g/24h; women with hypertension and proteinuria have proteinuria after 20 weeks of pregnancy (urinary protein ≥0.3g/24h or urine protein ≥ ( ) is defined as a significant increase in proteinuria or a progressive increase in blood pressure or any of the severe preeclampsia

Systolic blood pressure ≥140mmhg and diastolic blood pressure ≥90mmhg before pregnancy or before 20 weeks of pregnancy, with no obvious aggravation during pregnancy

Hypertension is first diagnosed after 20 weeks of pregnancy and persists beyond 12 weeks postpartum

Cerebral vasospasm and increased permeability can cause brain tissue hypoxia, edema, ischemia, intramicrovascular thrombosis, hemorrhage, or softening of local brain parenchymal tissue, resulting in dizziness, headache, nausea, vomiting, blurred vision, etc., and even convulsions, coma

Extensive cerebral edema can lead to increased intracranial pressure and even brain herniation.

Glomerular capillary spasm and hypoxia, glomerular dilation, endothelial cell swelling, and cellulose deposition in endothelial cells

Leakage of plasma proteins from the glomerulus causing proteinuria

Vasospasm leads to a decrease in renal blood flow, a decrease in glomerular filtration rate, an increase in plasma uric acid concentration, and an increase in plasma creatinine to twice that of normal pregnancy. Oligouria, edema, proteinuria, and casts may occur. In severe cases, renal failure may occur.

Vasospasm, peripheral resistance increases, blood pressure rises, cardiac output significantly decreases, and the cardiovascular system shows low discharge and high resistance.

Activation of endothelial cells increases vascular permeability, intravascular fluid enters the interstitium, and interstitial water and sodium retention leads to myocardial ischemia, interstitial edema, myocardial punctate hemorrhage and necrosis, and pulmonary edema.

Increased blood viscosity increases the burden on the heart, and in severe cases, heart failure may occur.

Spasm of small arteries throughout the body, increased permeability of blood vessel walls, blood concentration, and increased hematocrit

Preeclampsia is often accompanied by a hypercoagulable state caused by a certain amount of activation or mutation of coagulation factors.

Severe patients may develop microangiopathic hemolysis, manifested as thrombocytopenia, elevated liver enzymes, and hemolysis.

Abnormal liver function, elevated transaminase levels, and elevated plasma alkaline phosphatase may occur in preeclampsia.

Periportal hemorrhage and necrosis around the liver lobules are characteristic injuries of the liver

Bleeding caused by injury can cause subcapsular hematoma formation and even liver rupture.

Spasm of retinal arterioles, tissue ischemia and edema, may cause visual impairment, blurred vision, and in severe cases, retinal detachment and sudden blindness.

Spasm of small uterine blood vessels, insufficient recasting of uterine spiral arterioles, and the average diameter of spiral arteries is only half of that of normal pregnant women, resulting in insufficient blood supply to the placenta and decreased placental function, resulting in oligohydramnios, fetal growth restriction, fetal distress, and even fetal death.

Placental abruption caused by rupture of retroplacental blood vessels

Pregnant women whose weight increases ≥0.9Kg per week or 2.7kg every 4 weeks may develop invisible edema

It usually starts from the ankle and gradually extends to the ankle, which is pitting edema that does not subside after resting.

Edema limited to the ankles and calves is represented by , extending to the thighs is represented by , extending to the vulva and abdominal wall is represented by , generalized edema or accompanied by abdominal effusion is represented by .

rest, food

Closely monitor the condition of mother and child

Hypertensive patients with systolic blood pressure ≥140mmhg and diastolic blood pressure ≥90mmhg should use antihypertensive drugs

Pregnant women without organ damage control systolic blood pressure 130-155mmhg diastolic blood pressure 80-105mmhg

Control organ damage in pregnant women: systolic blood pressure 130-139mmhg, diastolic blood pressure 80-89mmhg (not lower than 130/80mmhg, to ensure uterine-placental blood perfusion, and blood pressure reduction should not fluctuate greatly)

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nifedipine

nimodipine

Nicardipine

Phentolamine

Nitroglycerin

sodium nitroprusside

First-line drugs for treating eclampsia and preventing seizures

Function control

usage

toxicity

It can eliminate patients' anxiety and tension, prevent and control eclampsia attacks

Diazepam: 2.5-5.0 mg orally, 2-3 times/d, or before going to bed. 10 mg intramuscularly or intravenously if necessary

Phenobarbital: The oral dose during sedation is 30 mg, 3 times/d. Intramuscular injection of 0.1g to control eclampsia

Hibernation mixture: composed of chlorpromazine (50mg), pethidine (100mg) and promethazine (50mg), usually 1/3-1/2 of the amount is intramuscularly injected, or half the amount is added to 250ml of 5% glucose solution for intravenous infusion. Since chlorpromazine can sharply drop blood pressure, reduce renal and placental blood flow, and cause certain damage to the liver of pregnant women and fetuses, and can also inhibit fetal breathing, it should only be used in cases where magnesium sulfate is ineffective in controlling convulsions.

It is generally not recommended that patients with generalized edema, acute heart failure, pulmonary edema, or cerebral edema may use rapid diuretics such as furosemide as appropriate.

Pregnant women with preeclampsia whose gestational age is <34 weeks and expected to give birth within 1 week should receive glucocorticoid treatment to promote fetal lung maturation.

Can reduce the incidence of neonatal respiratory distress syndrome

Dexamethasone 6 mg intramuscularly, once every 12 hours, a total of 4 times. Or betamethasone 12 mg intravenously, once every 12 hours, a total of 2 times.

If after the initial fetal lung stimulation, conservative treatment has been performed for a period of time (about 2 weeks), and the gestational age is still <34 weeks, the same dose of fetal lung maturity stimulation treatment can be given again.

Hypertension during pregnancy, if the condition does not reach severe preeclampsia, can be expected after 37 weeks of pregnancy

If the treatment of severe preeclampsia is not effective, it is recommended to terminate it.

Termination of pregnancy may be considered after eclampsia is controlled

Consider natural birth first, and no longer consider relaxing the indications for cesarean section