Classification of Hypertensive States of Pregnancy
Posted by Laura on January 23, 2010
Hypertension is defined as a systolic BP greater than 140mm Hg or a diastolic BP greater than 90 mm Hg. There must be 2 measurements at least 4-6 hours apart for diagnosis.
Proteinuria is a concentration of >30 mg/dl in a random urine specimen, or >300 mg/24 hours (preferred method).
Pathologic edema + generalized accumulation of fluid of the face, hands, or abdomen not responsive to 12 hours of bed rest – or rapid weight gain of more than 2kg in 1 week. (this is no longer considered a diagnostic of preeclampsia alone)
Preeclampsia progresses from mild to severe preeclampsia, to HELLP syndrome or eclampsia.
- systolic 160 or diastolic 110
- proteinuria > 2g in 24 hr
- oliguria < 500 ml / 24 hrs
- hepatic involvement
- thrombocytopenia w/platelet < 100,00/mm3
- pulmonary edema or cyanosis
fetal growth restriction
- H – hepatic dysfunction characterized by hemolysis
- EL – elevated liver enzymes
- LP – low platelets < 100,000/mm3
Lab Tests: Blood
- CBC (including a platelet count)
- clotting studies (bleeding time, PT, PTT, fibrinogen)
- Liver enzymes (lactate dehydrogenase LDH, AST, ALT
- Chemistry panel (BUN, creatine, glucose, uric acid
- Type and screen
- volume of at least 30 ml/hr, or 120 ml/4 hr
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