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Induced hypertension complicated HELLP syndrome treatment

Most pregnant patients with heart disease through a smooth pregnancy. However, due to pregnancy, cardiac output, blood volume and increase the workload of the entire circulatory system, greatly increase the load on the heart, which could prompt further decline in cardiac function was sick and lead to heart failure, or even serious consequences. A maternal effect on the heart in the heart of the burden of a significant change in pregnancy, mainly as oxygen consumption, cardiac output and blood volume increase. Blood volume increased by 40% to 50%, an average increase of about 1500ml of blood, the main increase in plasma, and thus the relative decline in red blood cells and hemoglobin concentration. This change reduces the blood viscosity and blood flow advantage. The pregnant uterus near term, especially when the oppression of the inferior vena cava obstruction of blood return, cardiac output decreased. These changes increased burden on the heart, it gradually from 14 weeks faster heart rate about 15 times / minute, 24 hours increased by about 14,000 times or so. Diaphragm increased in late pregnancy,[link widoczny dla zalogowanych], the heart to the left, on the shift, large blood vessels distorted, change the location of the heart blood vessels also increased the burden on the heart, but in the normal heart has a compensatory function can afford. Such as heart disease or heart failure occurs when the performance of early heart failure. , The burden of labor further aggravated after the heart, cardiac output during each contraction increased by 20% to 30%, so about 250 ~ 30Oral sinusoidal blood from the uterus out. In addition, the uterus towards the abdominal wall contraction of the uterus on the inferior vena cava to reduce the pressure, change thy blood flow also contributed to the reason for the increase in cardiac output. Second stage, after the breath holding force extreme pressure to increase the pulmonary circulation, combined with the abdominal muscles and the contraction of muscles are involved in the peripheral circulation also increases the resistance and change thy blood. Burden on the heart is more important than the first stage of labor. In the third stage of labor after the fetus suddenly shrink the uterus, uterine sinusoid, sudden influx of large amounts of blood within the blood circulation, the pregnant uterus on the inferior vena cava of oppression will disappear, lower extremity venous pressure in the role of high, but also a large number of blood return human heart,[link widoczny dla zalogowanych], which suddenly increased the burden of heart, but after giving birth a sudden drop in intra-abdominal pressure, blood can suddenly shed splanchnic vascular area and reduce the change thy blood. Birth occurred in a very short period of time such a big change for heart disease is indeed a critical time mothers often can not adapt to this change of heart and heart failure. In summary, the heart of the load gradually increased with the progress of pregnancy, especially the last few weeks of pregnancy, perinatal and postnatal stages of the heaviest load of the heart within a few days,[link widoczny dla zalogowanych], can easily cause cardiac dysfunction and heart failure. 2 of heart failure during pregnancy is the beginning of the diagnosis of progressive heart failure, such as well monitoring, early detection and timely treatment, the prognosis is different. Pregnancy induced heart failure causes are: rheumatic heart disease; congenital heart disease; pregnancy-induced hypertension heart disease; week growing period cardiomyopathy; severe anemia; when hypoproteinemia induced pleural effusion and increased cardiac load for any reason such as postpartum hemorrhage, such as too much too quickly after infusion may be caused by heart failure or heart failure. 2.1 2.1.1 The clinical manifestations of heart failure symptoms ① palpitations: heart rate of patients, consciously palpitation, this is due to reduction of left cardiac output, reflex increase in heart rate due to increase cardiac output. ② fatigue, weakness: limb weakness, easy fatigue, generally feeling tired after physical activity. This is due to reduced cardiac output, organ movement due to insufficient blood supply. ③ difficulty breathing: With the aggravation and shortness of breath after light physical activity, and finally even in the resting state, have difficulty breathing. This is due to reduced lung compliance and pulmonary bleeding and to reduce the permeability of alveolar gas exchange caused by severe paroxysmal nocturnal dyspnea may occur, that the night sleeping in a sudden chest tightness, shortness of breath and have to sit or stand arousal cube can be alleviated. ④ cough or hemoptysis without reason: many in the exertion or at night when supine attack, cough or sputum coughed up pink foam, or blood stained sputum. ⑤ cyanosis: mitral stenosis in peripheral parts of cyanosis, to form a ⑥ right heart failure: can have loss of appetite, nausea, abdominal distension; scanty urine, liver tenderness, and jaundice,[link widoczny dla zalogowanych], jugular vein engorgement and so on. 2.1.2 Signs ① Heart: apex beat when the diffusion of rheumatic heart disease, diastolic apex palpable tremor. Diastolic rumble can be heard like the murmur of mitral stenosis. When associated with mitral regurgitation, the apex beat is moved to the left, the apex can be heard blowing systolic murmur in the right kind of heart failure when jugular vein engorgement, the apex to the sides to expand. ② lungs: wheezing could be heard and or dry, wet 哕 sound. ③ hepatomegaly with tenderness. ④ edema: often occurred in the jugular vein distention and hepatomegaly, the late systemic edema may develop. ⑤ pleural effusion, ascites, pericardial effusions. 2.2 The auxiliary examination ECG, x-ray examination and echocardiography,[link widoczny dla zalogowanych], the current clamor Jiang echocardiography ll Ⅱ | friends ■ ■ ah r
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