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Preeclampsia
• Stable edema
• Proteinuria
The Zangemeister
• Arterial Classical Triad (1913)
hypertension
CLINICAL FEATURES
• Additional investigations:
– daily BP monitoring;
– hemostasiogram (thromboelastography, APTT, platelet count and
aggregation,
– fibrinogen and its degradation products, endogenous heparin
concentration,
– antithrombin III);
– ultrasound of mother’s vital organs;
– ultrasound fetometry;
– CTG;
– dopplerometry of maternal and fetal hemodynamics;
– ocular fundus examination;
– lupus anticoagulant;
– ECG.
THERAPY OF PREECLAMPSIA
Infusomat
Antihypertensive therapy:
Upon admitting the patient to the delivery department, one performs the
following procedures:
• summon the responsible obstetrician-gynecologist on duty, intensive care
specialist, neonatologist;
• fill out the intensive surveillance chart;
• provide the intravenous access: peripheral vein catheterization (18G);
• BP monitoring: at moderate arterial hypertension once an hour at least, at
severe hypertension — continuous monitoring;
• continue antihypertensive and anticonvulsant therapy (if it was initiated
earlier) at previous doses, and adjust them according to indications;
• provide adequate analgesia of labor (pharmaceutical analgesia as
indicated). The gold standard of analgesia is epidural nerve block;
• perform early amniotomy;
• do not routinely limit the duration of the second stage of labor if the
mother’s and fetus’s condition is stable.
POSTPARTUM PERIOD MANAGEMENT