Acute Severe Hypertension in pregnancy

Veerendrakumar C.M. MD., DNB. Associate professor VIMS, Bellary. [email_address] 09/06/10

Major Killers - A P E S ,[object Object],[object Object],[object Object],[object Object],09/06/10

Safe motherhood initiative… 300 to 30 in 3 years ,[object Object],[object Object],[object Object],09/06/10

Hypertensive crises deaths difficult to treat 09/06/10

Hypertensive crises ,[object Object],[object Object],[object Object],[object Object],09/06/10

Causes of maternal mortality in VIMS study of 513 patients Joshi et al 2003-2007 09/06/10 Intracranial Hemorrhage 10 58.8% Pulmonary edema 5 29.4% Ante partum hemorrhage 1 5.9% Acute renal failure 1 5.9%

VIMS study – Joshi et al ,[object Object],09/06/10

Mean MAP 124.2 mm of Hg Joshi et al ,[object Object],[object Object],[object Object],09/06/10 MAP no of pts %

VIMS study 164 pts ( 1997-1999) ,[object Object],[object Object],09/06/10

Vicious cycle ,[object Object],[object Object],[object Object],Vasoactive amines 09/06/10

RCOG 2006 ,[object Object],[object Object],09/06/10

[object Object],[object Object],09/06/10

Indications for treatment ,[object Object],[object Object],[object Object],09/06/10

Anti- HT treatment in mild HTN ,[object Object],[object Object],[object Object],09/06/10

What precedes Severe HTN ? ,[object Object],09/06/10

Different standards for treatment ,[object Object],09/06/10

[object Object],[object Object],[object Object],[object Object],09/06/10

Finally Sibai …. ,[object Object],[object Object],09/06/10

Auto regulation ,[object Object],[object Object],09/06/10

Altered auto regulation ,[object Object],[object Object],09/06/10

Placental blood flow is not auto regulated ,[object Object],[object Object],[object Object],[object Object],09/06/10

Bitter reality ! ,[object Object],09/06/10

In India ,[object Object],[object Object],09/06/10

RCOG Guideline No. 10(A) March 2006 ,[object Object],09/06/10

The Confidential Enquiries ,[object Object],09/06/10

[object Object],[object Object],[object Object],09/06/10

Dilemmas… ,[object Object],[object Object],[object Object],09/06/10

Labetalol ,[object Object],09/06/10

Labetalol preferred ,[object Object],[object Object],[object Object],09/06/10

Labetalol ,[object Object],[object Object],[object Object],[object Object],09/06/10

Cochrane Data base Syst Rev. 2007 ,[object Object],Abalos E, Duley L, Steyn D, Henderson-Smart D. 09/06/10

Nifedipine ,[object Object],[object Object],[object Object],09/06/10

Nifedipine ,[object Object],09/06/10

Nifedepine & MgSO 4 ,[object Object],[object Object],09/06/10

A degree ofcomplacency ? 09/06/10

labetalol ,[object Object],[object Object],09/06/10

labetalol ,[object Object],09/06/10

Pharmacology-Labetalol ,[object Object],[object Object],[object Object],[object Object],[object Object],09/06/10

hydrallazine ,[object Object],[object Object],[object Object],09/06/10

Critical care Obstetrics ,[object Object],[object Object],[object Object],09/06/10

www.vimsobg.com ,[object Object],Thank you 09/06/10

Acute Severe Hypertension in pregnancy

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Acute Severe Hypertension in pregnancy