Gestational hypertension and heart disease during pregnancy is unique to the disease, China's incidence rate of 9.4 percent, the majority of cases appear in a pregnancy had hypertension, proteinuria, and other symptoms of a small number of patients with hypertension during pregnancy for the development of heart disease leading to acute heart failure Pregnant women is the leading cause of death, on the diagnosis and treatment must actively accurate.
Gestational hypertension and heart disease during pregnancy is unique to the disease, China's incidence rate of 9.4 percent, the majority of cases appear in a pregnancy had hypertension, proteinuria, and other symptoms, a small number of patients with hypertension during pregnancy for the development of heart disease leading to acute heart failure Pregnant women is the leading cause of death, on the diagnosis and treatment must actively accurate.
1 clinical data
1.1 general information in August 2003 to August 2006 in our hospital treated five cases of gestational hypertension and heart disease leading to acute left ventricular failure patients, aged 24 to 30-year-old, four cases of early maternal, is the one case of maternal, pregnant 38 To 40 weeks, according to diagnostic criteria, "Obstetrics and Gynecology" version 6, in the end of active control of heart failure after birth mother recovered and discharged. Finishing the collection of medical education network
1.2 Treatment Methods seat, his legs , with oxygen masks and effective so that the arterial pressure (PO2)> 60 mmHg, morphine started to 2 ~ 8 mg intravenous if necessary, every 2 ~ 4 h repeat administration, Furosemide 40 mg +10% of 20 ml of intravenous glucose, Portland West and 0.2 ~ 0.4 mg +25% of 20 ml of intravenous glucose, 24 h does not exceed 0.8 mg, and pay attention to electrolyte balance, maintaining a certain level of potassium concentration, Hypokalemia should avoid the situation caused by digitalis poisoning; vasodilative drug commonly used SNP 25 mg +5% glucose infusion pump 250 ml to 10 μ g / min start typing, with an average 3 μ g / (kg min) to reduce the speed of the former Load.
Typical cases
Patients, 25-year-old, 40 weeks pregnant, December 25, 2003 due to pregnancy hypertension and heart disease leading to acute left ventricular failure hospitalization, Duanzuo breathing, pink bubble-like cough sputum collection of finishing medical education network. Investigations of: BP 160/120 mmHg, P 110 times / min, R 25 times / min. Cardiac auscultation: diastolic Benma law, can be heard at the end of Shuangfei and wet La Music, cyanosis, continuing the jugular Nuzhang. ECG Tip: sinus tachycardia, the left atrium and left ventricle, immediately to rescue heart failure treatment in a stable condition, will lower the end of the cesarean birth, hospital 15 days to recover and discharged.
3 discussion
Gestational hypertension diseases caused vasospasm, hypertension, peripheral resistance increased, myocardial contraction and increased ejection resistance, cardiac output decreased significantly, the cardiovascular system in a low-ranked high resistance, and ventricular function in a high-power status, coupled with Activation of endothelial cells to increase vascular permeability, vascular fluid into the cell, leading to myocardial ischemia, interstitial edema, or myocardial necrosis point bleeding, pulmonary edema, caused serious heart failure [1]. These patients with no previous signs and symptoms of heart disease, suddenly left the main symptoms of heart failure, often dry cough, night obviously, easily mistaken for upper respiratory tract infection and bronchitis, or delay treatment time. Therefore, the importance of timely diagnosis, early intervention and treatment to reduce heart load, mainly diuretic, cardiac drugs instead advocated by a small number of saturation, because this is the main reason for heart failure around the small arteries to increase resistance, water, sodium retention and blood viscosity Increase in early control of heart failure at the same time an emergency Cesarean section.
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