10.1a Preeclampsia and Hypertension

Question 1

Hypertensive Disorders

Answer 1

• Common medical complication of pregnancy and are a major cause of perinatal morbidity and mortality

Question 2

Hypertension

Answer 2

• BP greater than 140/90 (either 140 or 90)
• Recorded on 2 separate occasions at least 4 hours apart
• Recorded after 20 weeks of gestation

Question 3

Gestational Hypertension

Answer 3

• Onset of hypertension without proteinuria or other diagnostics of pre-eclampsia after week 20 of pregnancy
• Did not have hypertension before the pregnancy

Question 4

Preeclampsia

Answer 4

• Development of hypertension with proteinuria in a previously normal woman after 20 weeks of gestation or early post-partum
• If there is no proteinuria can also be with new onset of thrombocytopenia, renal insufficiency, impaired liver function, edema, or cerebra/visual symptoms

Question 5

Eclampsia

Answer 5

• Development of seizure/coma not due to other causes in preeclamptic women

Question 6

Chronic Hypertension

Answer 6

• Hypertension was present in woman before pregnancy

Question 7

Superimposed Preeclampsia

Answer 7

• Chronic Hypertension in association with preeclampsia

Question 8

Preeclampsia

Answer 8

• Pregnancy specific condition
• Hypertension and proteinuria develop after 20 week gestation in a woman who previously had neither condition
• Can also develop during post-partum
• Leading cause of maternal and perinatal morbidity/mortality

WITHOUT PROTEINURIA CAN ALSO BE DUE TO HYPERTENSION WITH

• Thrombocytopenia
• Impaired liver function
• New-Onset Renal Insufficiency
• Pulmonary Edema
• New-Onset Cerebral/Visual Disturbances

Question 9

Preeclampsia

Answer 9

• BP greater than 140/90
• Proteinuria greater than 300 mg in a 24 hour specimen
• Platelets less than 100,000 uL
• Elevated blood levels of liver enzymes 2x the normal concetration
• Renal insufficiency serum creatinine >1.1 or double baseline
• No pulmonary edema
• No cerebral or visual disturbances

Question 10

Preeclampsia with Severe Features

Answer 10

• BP greater than 160/110
• Massive proteinuria >5g in a 24 hour specimen (no longer used as a criteria)
• Platelets <100,000
• Liver enzymes twice the normal WITH severe epigastric/RUQ abdominal pain that is not responsive to medications or due to other causes
• Pulmonary Edema Present
• New onset of visual/cerebral disturbances

Question 11

HELLP Syndrome

Answer 11

• N/V, Epigastric and RUQ Pain
• Headache
• Visual Changes
• Jaundice
• Signs of preeclampsia without rise in blood pressure or proteinuria