Cüneyt Evrüke

PROF.DR.İ.CÜNEYT EVRÜKE ÇUKUROVA ÜNİVERSİTESİ TIP FAKÜLTESİ KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI GAZİANTEP ,2 2 / 11 /2009

SINIFLAMA ,[object Object],[object Object],[object Object],[object Object],[object Object]

The Society of Obstetricians and Gynecologists of Canada (SOGC) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

HİPERTANSİYON ,[object Object],[object Object],[object Object],Working Group on High Blood Pressure in Pregnancy. Working Group on High Blood Pressure in Pregnancy. National Instutes of Health Washington,DC 2000

KRONİK HİPERTANSİYON ,[object Object],[object Object],[object Object],Working Group on High Blood Pressure in Pregnancy. Working Group on High Blood Pressure in Pregnancy. National Instutes of Health Washington,DC 2000

KRONİK HİPERTANSİYON ÜZERİNE EKLENMİŞ PREEKLAMPSİ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Working Group on High Blood Pressure in Pregnancy. Working Group on High Blood Pressure in Pregnancy. National Instutes of Health Washington,DC 2000

GESTASYONEL HİPERTANSİYON ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Working Group on High Blood Pressure in Pregnancy. Working Group on High Blood Pressure in Pregnancy. National Instutes of Health Washington,DC 2000

Sistolik kan basıncı ≥ 140 mmHg veya Diyastolik kan basıncı ≥ 90 mmHg Proteinuri (≥ 0.3 gr/24 st) + Önceden kan basıncı normal olan kadında; 20. gebelik haftasından sonra ortaya çıkan hipertansiyon ve proteinüri;PREEKLAMPSİ MİKRO ANJİOPA T İ

FİZYOPATOLOJİ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Yetersiz Trofoblast İnvazyonu, Plasentasyon Defekti Genetik faktörler İmmünolojik faktörler Çevresel faktörler Plasental İskemi – Hipoksi Plasental Biyolojik Moleküllerin Anormal Aktivasyonu Dolaşımdaki Biyolojik Moleküllerin Artışı Sistemik Endotelial Disfonksiyon Vazodilatatör/Vazokonstriktör Mediatör Dengesinde Bozulma Preeklampsi Klinik Belirtileri

Vazokonstruksiyon Platelet agregasyonu Azalmış uteroplasental kan akımı Tromboksan Prostasiklin

Preeklampside sitotrofoblastlar spiral arterlerin desidual kısmını invaze ederken myometrial kısıma penetre olamazlar ve damar yüksek dirençli kalır ve hipoperfüzyon gelişir NORMOTENSİF PREEKLAMPTİK

İMMUNOLOJİK FAKTÖRLER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

GENETİK YATKINLIK ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MORTALİTE/MORBİDİTE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PREEKLAMPSİ ,[object Object],[object Object],[object Object],Lain, KY,Roberts JM. Contemporary Concepts of the pathogenesis and management of preeclampsia. JAMA 2002;287:3183

MATERNAL KOMPLİKASYONLAR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

FETAL KOMPLİKASYONLAR ,[object Object],[object Object],[object Object],[object Object]

PREEKLAMPSİ-BEYİN Eklamptik konvülziyonlar sonrası hastaların % 75 inin EEG isinde geçici nonspesifik anormal bulgular, BBT de hemoraji ve lokal ödem bulguları saptanmıştır.

PREEKLAMPSİ-KARACİĞER Periportal fibrin birikimi ve zonal iskemi Periportal hemorajik nekroz Subkapsüler hematom

PREEKLAMPSİ-BÖBREK ,[object Object],[object Object],[object Object],[object Object]

PREEKLAMPSİ-AKCİĞER Yaygın ödem Sıvı yüklenmesi Akciğer ödemi

PREEKLAMPSİ-RİSK FAKTÖRLERİ 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Working Group on High Blood Pressure in Pregnancy. National Instutes of Health Washington,DC 2000

PREEKLAMPSİ-RİSK FAKTÖRLERİ 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dekker G, Sibai B. Primary, secondary, and tertiary prevention of pre-eclampsia. Lancet 2001;357:209-215.

PREEKLAMPSİDE RİSK FAKTÖRLERİ-3 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

HAFİF PREEKLAMPSİ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ŞİDDETLİ PREEKLAMPSİ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EKLAMPSİ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PREEKLAMPSİ GELİŞİMİ-1.TRİMESTER’DE TAHMİN EDİLEBİLİR Mİ?? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TEDAVİ-MEDİKAL BAKIM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MEDİKAL BAKIM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Villar, J, Abalos,E and et.al. Strategies to prevent and treat preeclampsia. Semin Nephrol 2004;24;607 Onwude JL, Lilford RJ, Hjartardottir H, et al. A randomised double blind placebo controlled trial of fish oil in high risk pregnancy. Br J Obstet Gynaecol . Feb 1995;102(2):95-100

MEDİKAL BAKIM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

GEBELİĞİN YÖNETİMİ-TEMEL PRENSİPLER ,[object Object],[object Object],[object Object],[object Object]

PREEKLAMPSİ TEDAVİSİNDE AMAÇ ,[object Object],[object Object],[object Object],[object Object]

HAFİF PREEKLAMPSİDE YÖNETİM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ANTENATAL TAKİP ,[object Object],[object Object],[object Object],[object Object],[object Object]

ŞİDDETLİ PREEKLAMPSİ ,[object Object],[object Object],[object Object]

ŞİDDETLİ PREEKLAMPSİ-YÖNETİM 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ŞİDDETLİ PREEKLAMPSİ-YÖNETİM 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ŞİDDETLİ PREEKLAMPSİ-YÖNETİM 3 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EKLAMPSİ-YÖNETİM 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EKLAMPSİ-YÖNETİM 2 ,[object Object],[object Object],[object Object],[object Object],[object Object]

EKLAMPSİ-YÖNETİM 3 ,[object Object],[object Object],[object Object],[object Object],[object Object]

EKLAMPSİ-YÖNETİM 4 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NE ZAMAN MEDİKASYON ?? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ALFA ADRENERJİK İNHİBİTÖRLER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

LABETALOL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

BETA-ADRENERJİK RESEPTÖR BLOKÖRLERİ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

KALSİYUM KANAL BLOKÖRLERİ-NİFEDİPİNE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

HİDRALAZİNE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

NİTROPRUSSİDE ,[object Object],[object Object],[object Object],[object Object],[object Object]

NİTROGLİSERİN ,[object Object],[object Object],[object Object],[object Object]

HANGİ ANTİHİPERTANSİFLERİ KULLANMAYALIM ?? ,[object Object],[object Object],[object Object],[object Object]

EMZİRME DÖNEMİNDE İLAÇ SEÇİMİ ,[object Object],[object Object],[object Object],[object Object],[object Object],Sibai, BM.Chronic hypertension of pregnancy. Obstet Gynecol 2002;100:369

ANTİ-KONVÜLSİF TERAPİ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MAGNEZYUM SÜLFAT TEDAVİSİ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MAGNEZYUM TOKSİSİTESİNDE YAKLAŞIM MAGNEZYUM TOKSİSİTESİ VE TEDAVİ

HELLP SENDROMU ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

HELLP-PROGNOZ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ANAHTAR NOKTALAR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cüneyt Evrüke

Recomendados

Recomendados

Mais conteúdo relacionado

Mais procurados

Mais procurados (19)

Semelhante a Cüneyt Evrüke

Semelhante a Cüneyt Evrüke (20)

Cüneyt Evrüke