Postnatal care Although delivery is

Postnatal care
Although delivery is the cure for pre-eclampsia and related disorders, resolution is often not immediate and many women may initially deteriorate after birth, or re-present some days later with worsening disease.

Postpartum hypertension
In normal pregnancy, blood pressure falls immediately after birth and peaks 3–6 days later. In hypertensive women, this is also the case, and women frequently experience a further spike in their blood pressure several days postpartum. In fact, 32-44% of all eclampsia occurs postpartum, so continued vigilance is essential (Bramham et al, 2013). Other factors that can cause or exacerbate hypertension postpartum are pain, anxiety, the use of certain drugs (such as ergometrine) and fluid overload in labour. These factors should be assessed, and analgesia and fluid management adjusted as necessary before altering antihypertensive therapy.

Post-pregnancy debriefing and planning for future health
It is important that women clearly understand their diagnosis and the rationale for any interventions during pregnancy. Ideally, the senior clinician involved would have the opportunity to debrief the woman postnatally, but in reality this task often falls to the midwives and junior doctors on the postnatal wards. For more complicated cases a formal postnatal debriefing appointment should be arranged.

It is important to convey the following three messages:
l Exact diagnosis: type of hypertensive disorder and any other organ systems affected l Need for early booking and surveillance in the next pregnancy. For women with pre-eclampsia, the risk of recurrence is related to the gestation at which this baby was delivered (Bramham et al, 2013). Women with a history of pre-eclampsia should be seen by an obstetrician, and should start low-dose aspirin (75 mg a day) early in future pregnancies
l Long-term health implications—all women with hypertension in pregnancy have an increased risk (approximately double) of cardiovascular disease, chronic hypertension, venous thromboembolism and cerebrovascular disease in the future (Irgens et al, 2001; Smith et al, 2001; Ray et al, 2005; Bellamy et al, 2007). Simple lifestyle and dietary advice may help women manage their personal risk of medical complications in later life. Women should be advised that, as they get older, they should control their weight, take regular exercise and have annual blood pressure and cholesterol checks. This is, of course, good advice for us all, but is particularly important for women who have had pre-eclampsia.

ผลลัพธ์ (ไทย) 1:

Postnatal care Although delivery is the cure for pre-eclampsia and related disorders, resolution is often not immediate and many women may initially deteriorate after birth, or re-present some days later with worsening disease. Postpartum hypertension In normal pregnancy, blood pressure falls immediately after birth and peaks 3–6 days later. In hypertensive women, this is also the case, and women frequently experience a further spike in their blood pressure several days postpartum. In fact, 32-44% of all eclampsia occurs postpartum, so continued vigilance is essential (Bramham et al, 2013). Other factors that can cause or exacerbate hypertension postpartum are pain, anxiety, the use of certain drugs (such as ergometrine) and fluid overload in labour. These factors should be assessed, and analgesia and fluid management adjusted as necessary before altering antihypertensive therapy. Post-pregnancy debriefing and planning for future health It is important that women clearly understand their diagnosis and the rationale for any interventions during pregnancy. Ideally, the senior clinician involved would have the opportunity to debrief the woman postnatally, but in reality this task often falls to the midwives and junior doctors on the postnatal wards. For more complicated cases a formal postnatal debriefing appointment should be arranged. It is important to convey the following three messages: l วินิจฉัยแน่นอน: hypertensive โรคและระบบอวัยวะอื่น ๆ ได้รับผลกระทบ l ต้องจองก่อนและเฝ้าระวังในการตั้งครรภ์ต่อไป สำหรับผู้หญิงที่มี eclampsia ก่อน ความเสี่ยงของการเกิดขึ้นจะเกี่ยวข้องกับครรภ์ที่ทารกนี้มีจัดส่ง (Bramham et al, 2013) ผู้หญิงที่ มีประวัติของ eclampsia ก่อนควรเห็นความอบอุ่น และควรเริ่มต่ำยาแอสไพริน (75 มิลลิกรัมต่อวัน) ในช่วงตั้งครรภ์ในอนาคต ผลกระทบสุขภาพระยะยาว l ซึ่งผู้หญิงทุกคน มีความดันโลหิตสูงในหญิงตั้งครรภ์มีความเสี่ยง (ห้อง) โรคหลอดเลือดหัวใจ ความดันโลหิตสูงเรื้อรัง ดำ thromboembolism และเฉพาะโรค cerebrovascular ในอนาคต (Irgens et al, 2001 Smith et al, 2001 เรย์ et al, 2005 เบลลามี et al, 2007) ชีวิตที่เรียบง่ายและแนะนำอาหารอาจช่วยจัดการความเสี่ยงส่วนบุคคลของภาวะแทรกซ้อนทางการแพทย์ในชีวิตภายหลังผู้หญิง ผู้หญิงควรทราบว่า เก่า พวกเขาควรควบคุมน้ำหนักของพวกเขา ใช้เวลาออกกำลังกายอย่างสม่ำเสมอ และมีความดันโลหิตประจำปีและการตรวจสอบไขมัน นี้ เป็น หลักสูตร แนะนำที่ดีสำหรับเราทั้งหมด แต่มีความสำคัญอย่างยิ่งสำหรับผู้หญิงที่มี eclampsia ก่อน