eclampsia symptoms
Introduction
Introduction Pre-eclampsia (also known as pre-eclampsia), formerly known as pregnancy toxemia, is a more complex disease that affects 5% to 8% of pregnant women. If you develop high blood pressure and urinary protein after 20 weeks of pregnancy, you will be diagnosed with pre-eclampsia. Most of these conditions begin to manifest after 37 weeks, but can also be manifested at any time during the second half of pregnancy, during childbirth, or even after childbirth (usually 24 to 48 hours after delivery). Pre-eclampsia is also likely to occur during the first 20 weeks of pregnancy, but this is rare, such as pregnant women with hydatidiform moles. The condition of pre-eclampsia varies from one to another, and the development is fast and slow. The only way to alleviate your condition is to give your baby out.
Cause
Cause
There are many theories about the pathogenesis of pre-eclampsia, such as imbalance of prostacyclin and thromboxane, immune abnormalities, increased vascular response to vasoactive agents, abnormal placenta, genetic variation of angiotensinogen gene, etc., but No one has been proven, the exact cause is still unclear.
The most important risk factor for pre-eclampsia is the history of pre-eclampsia in a first pregnancy or a previous pregnancy. Pre-eclampsia rarely occurs in prolific women who have had previous illnesses (the father who is not the fetus of this pregnancy is not the same person as before). There is currently no means of predicting pre-existing sputum, and the assessment of risk factors cannot distinguish which women are mild, which women are seriously ill and have multiple organ dysfunction.
Pre-eclampsia can be considered as a result of systemic small vasospasm. Vasospasm causes tissue ischemia, and the function of different affected organs changes.
Examine
an examination
Related inspection
Blood sugar, blood pressure, urine protein
There is no history of chronic hypertension, nephropathy and diabetes in the past. There is no convulsion in the history of pregnancy. There are edema, hypertension and egg white in the third trimester. There are symptoms of pre-eclampsia, especially primipara, twin pregnancy and polyhydramnios. In other cases, the diagnosis of pre-eclampsia is generally not difficult to be sure.
Basal body temperature measurement: Women with biphasic body temperature, the high temperature phase after menopause persisted for 18 days, and the possibility of early pregnancy was great.
Progesterone test: The principle of using progesterone to suddenly retreat in the body can cause uterine bleeding. Daily intramuscular injection of progesterone injection 20mg, for 3 days, after 2 to 7 days of withdrawal, if there is no vaginal bleeding for more than 7 days , the possibility of early pregnancy is great.
Cervical mucus examination: After the smear of the cervical mucus is dried, the ellipsoids arranged in a row are seen under the light microscope, and the possibility of early pregnancy is large.
Pregnancy test: Pregnant women's urine contains HCG, which is detected by enzyme-linked immunosorbent assay. If it is positive, it indicates that the subject contains HCG in urine, which can help diagnose early pregnancy.
B-mode ultrasound imaging: In the enlarged uterine contour, a circular aura from the amniotic sac is seen, and the dark circle (amniotic fluid) is inside the pregnancy ring. The pregnancy ring was first seen at 5 weeks of gestation. If a rhythmic fetal heartbeat and fetal movement are seen in the pregnancy ring, it can be diagnosed as an early pregnancy.
According to pre-existing and chronic nephritis uremia coma or hypertensive crisis of essential hypertension. Also need to differentiate with epilepsy. Have a history of treatment of pre-eclampsia, or do not make prenatal examination, sudden coma convulsions, or pregnant women with prenatal negligence treatment of pregnancy-induced hypertension, blood pressure 21.3/14.6kPa (160/llommHg), edema, proteinuria, etc., can be diagnosed as Eclampsia.
Diagnosis
Differential diagnosis
Mainly related to convulsions, coma, such as common epilepsy, encephalitis, cerebral hemorrhage, hypoglycemia, rickets and so on.
1. Seizures:
Patients with epilepsy have a history of seizures in the past. There are often auras before the attack, and the attack time is short. After the loss of the mind, they fall, and the whole body licks for 1 to 2 minutes. It can also bite the tongue and incontinence. However, most of them are awake immediately after convulsions, and even if there is a short coma or confusion, they can return to normal in a short time. No high blood pressure, edema and proteinuria. There is no change in the fundus at the fundus. The patient pays attention to the relevant medical history after convulsion and emergency treatment, checks the urine protein in time, and measures the blood pressure for rapid diagnosis.
2. Hypertensive encephalopathy and cerebral hemorrhage:
Patients should have a history of chronic hypertension before pregnancy, often without edema and proteinuria. Sudden coma, loss of consciousness, soft hemiplegia, positive pathological reflex, and asymmetry of pupil. When the cerebral hemorrhage has special changes in the cerebrospinal fluid, it can be diagnosed.
3. Encephalitis:
The onset of encephalitis is seasonal, and encephalitis is seen in summer and autumn. Epidemic encephalitis is more common in spring. Although the onset is urgent, but there are fever, headache, neck discomfort, rapid high fever, nausea, vomiting, irritability, coma, can also occur convulsions, convulsions. Patients with eclampsia had no fever, no neck stiffness and meningeal irritation, and no pathological reflex. Patients with encephalitis have no hypertension, edema, proteinuria, and typical inflammatory changes in cerebrospinal fluid examination.
There is no history of chronic hypertension, nephropathy and diabetes in the past. There is no convulsion in the history of pregnancy. There are edema, hypertension and egg white in the third trimester. There are symptoms of pre-eclampsia, especially primipara, twin pregnancy and polyhydramnios. In other cases, the diagnosis of pre-eclampsia is generally not difficult to be sure.
