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1. Gestational hypertension (without proteinuria). a- Developing antenatally. b- Developingfor the first time in labor. c- Developing for the first time in the purperium. 2. Gestational proteinuria (without Hypertension). a- Developingantenatally. b- Developingfor the first time in labor. c- Developingfor the first time in the purperium. 3. Gestational proteinurichypertension (Pre-eclampsia). a- Developingantenatally. b- Developing for the first time in labor. c- Developing for the first time in the purperium. II. Chronic hypertension and chronic renal disease: Review ofLiterature Hypertension and/or proteinuria in pregnancy in a woman with chroinc hypertension or chronic renal disease diagnosedbefore, during, or after pregnancy. This group is subdividedinto. 1. Chronichypertension(withoutproteinuria). 2- Chronic renal disease (proteinuria with or without hypertension). 3- Chronic hypertension with superimposed pre-eclampsia, proteinuria Developing for the first time during pregnancy in a woman with Known chronic hypertension. III. Unclassified hypertension and/or proteinuria: Hypertensionand/or proteinuriafound either: 1. At first examinationafter the twentieth week of pregnancy(140 days) in a woman with known chronichypertension or chronic renal disease, or 2. During pregnancy, labor, or the purperium, in a case in which informationis insufficient to permit classification? 25 ...-
This category is subdivided into: a- Unclassified hypertension (without proteinuria). b- Unclassified proteinuria (without hypertension). Review ofLiterature c-Unclassified proteinuric hypertension. (Davey and Mac Gillivary, 1988) DIAGNOSIS OF SEVERE PREECLAMPSIA Symptoms For the diagnosis of preeclampsia, the committee on terminology requires acute hypertension in the latter half of pregnancy with proteinuria, or facial, digital or generalized edema or both (Chesley, 1985). HEADACHE: Headache is unusual in milde cases but is increasingly frequent in more. severe disease. It is often frontal but may be occipital, and it is resistant to relief by ordinary analgesics. In women who develop eclampsia, severe headache almost invariably precedes the first convulsion (Cunningham et al., 1997). The cause ofheadache is usually inadequate blood pressure control, and it is an indication for aggressive treatment with hypotensive agents (Arias, 1993). EDEMA: Edema is included in the classic definition of preeclampsia and is used as a diagnostic feature in several classification system of hypertension in pregnancy. Pathological edema perhaps most notable in the face, occurs in 85 per cent of women with preeclampsia and is associated with a rapid increase in weight (Thomson et al., 1987). 26
- Page 3 and 4: ACKNOWLEDGMENT Above all and first
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This category is subdivided into:<br />
a- Unclassified hypertension (without proteinuria).<br />
b- Unclassified proteinuria (without hypertension).<br />
Review ofLiterature<br />
c-Unclassified proteinuric hypertension. (Davey and Mac Gillivary,<br />
1988)<br />
DIAGNOSIS OF SEVERE PREECLAMPSIA<br />
Symptoms<br />
For the diagnosis of preeclampsia, the committee on terminology<br />
requires acute hypertension in the latter half of pregnancy with<br />
proteinuria, or facial, digital or generalized edema or both (Chesley,<br />
1985).<br />
HEADACHE:<br />
Headache is unusual in milde cases but is increasingly frequent in<br />
more. severe disease. It is often frontal but may be occipital, and it is<br />
resistant to relief by ordinary analgesics. In women who develop<br />
eclampsia, severe headache almost invariably precedes the first<br />
convulsion (Cunningham et al., 1997). The cause ofheadache is usually<br />
inadequate blood pressure control, and it is an indication for aggressive<br />
treatment with hypotensive agents (Arias, 1993).<br />
EDEMA:<br />
Edema is included in the classic definition of preeclampsia and is<br />
used as a diagnostic feature in several classification system of<br />
hypertension in pregnancy. Pathological edema perhaps most notable in<br />
the face, occurs in 85 per cent of women with preeclampsia and is<br />
associated with a rapid increase in weight (Thomson et al., 1987).<br />
26
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