最近审阅: 4 十一月 2020
最近更新: 04 一月 2019

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/上腹部疼痛和触痛
  • 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
更多 首要检查

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
更多 需考虑的检查

治疗流程

撰稿人

Professor of Obstetrics and Gynecology

Vice Chair for Research and Academic Development

Director of the Divisions of Maternal-Fetal Medicine and Research

University of Mississippi Medical Center

Jackson

MI

利益声明

JNM Jr is a maternal-foetal medicine consultant and obstetrician gynaecologist to Mississippi Blue Cross Blue Shield and the Mississippi Perinatal Quality Collaborative. He is a member of several American Congress of Obstetricians and Gynecologists (ACOG) committees including the Global Operations Advisory Group, Compensation, and the Telehealth WorkGroup, chair of the ACOG 2018 Task Force on Pregnancy and Heart Disease, and a member of the International Federation of Gynecology and Obstetrics (FIGO) Non-communicable Diseases Committee. He is a teacher, lecturer, and speaker about HELLP syndrome for the ACOG, Federación LatinoAmericana de Sociedades de Obstetrícia y Ginecologia (FLASOG) and Mexican Federation of Colleges of Obstetrics and Gynecology (FEMECOG). JNM Jr is also an author of a number of references cited in this topic.

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

同行评议者展开全部内容

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.

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.

内容使用需遵循免责声明