最后审阅: 21 九月 2021
最后更新: 10 三月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 恶心/呕吐
  • 高血压
  • 腱反射活跃

其他诊断因素

  • 右上腹/上腹疼痛和压痛
  • 全身不适感
  • 头痛
  • 水肿
  • 视觉障碍
  • 黄疸
  • 出血

危险因素

  • 白种人
  • 孕妇年龄>35 岁
  • 肥胖
  • 慢性高血压
  • 糖尿病
  • 自身免疫性疾病
  • 多胎妊娠
  • 胎盘形成异常(例如葡萄胎妊娠)
  • 既往出现子痫前期伴有或不伴有 HELLP 综合征的妊娠

诊断性检查

首要检查

  • 全血细胞计数加分类,包括血小板
  • 外周血涂片
  • 肝脏氨基转移酶
  • 胆红素水平
  • 总血清 LDH 水平
  • 尿酸水平
  • 尿液分析和蛋白质与肌酐比值
  • PT/PTT
  • 纤维蛋白原水平
  • 胎儿超声检查

需考虑的检查

  • 血清葡萄糖水平
  • 血清肌酐和电解质水平
  • 抗凝血酶水平
  • 结合珠蛋白水平
  • 孕妇上腹部超声、CT 或 MRI
  • 乳酸脱氢酶 (LDH) 与天冬氨酸氨基转移酶 (AST) 比值

治疗流程

撰稿人

作者

James N. Martin, Jr, MD, FACOG, FAGOS, FAHA, F(H)RCOG

Professor Emeritus of Obstetrics, Gynecology, and Maternal-Fetal Medicine

University of Mississippi Medical Center

Jackson

MI

利益声明

JNM Jr is an obstetrician-gynaecologist and maternal-fetal medicine consultant to BlueCross & BlueShield of Mississippi and the Mississippi Perinatal Quality Collaborative. He is co-director of the Mississippi Maternal Mortality Review Committee. He serves on the Global Operations Advisory Group of the American College of Obstetricians and Gynecologists (ACOG), and in 2018-9 he chaired the ACOG Presidential Task Force on Pregnancy and Heart Disease. JNM Jr lectures, teaches, researches, and speaks nationally and internationally on the subjects of hypertensive complications of pregnancy, including HELLP syndrome. He is also the lead author and editor of 'The 2015 compendium for HELLP syndrome: from bench to bedside' (Nova Biomedical Publishers). JNM Jr is an author of several references cited in this topic. He has cited his own papers in this topic.

鸣谢

Dr James N. Martin Jr would like to gratefully acknowledge Dr Marium G. Holland and Dr Alex C. Vidaeff, the previous contributors to this topic.

利益声明

MGH declares that she has no competing interests. ACV is an author of a number of references cited in this topic.

同行评议者

Jerome Yankowitz, MD

Professor and Director

Division of Maternal-Fetal Medicine

Department of Obstetrics and Gynecology

University of Iowa Hospitals and Clinics

Iowa City

IA

利益声明

JY declares that he has no competing interests.

Deirdre Murphy, MD, MRCOG

Professor of Obstetrics

Trinity College

University of Dublin

Consultant Obstetrician

Coombe Women and Infants University Hospital

Dublin

Ireland

利益声明

DM declares that she has no competing interests.

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