ASN Pregnancy

Question 1

what % of all pregnancies are complicated by HTN

Answer 1

5-10%
-more common in diabetic nephropathy

Question 2

Risk factors for gestational HTN

Answer 2

advanced maternal age, family hx, prior h/o htn, CKD, obesity, diabetes

Question 3

CHAP study

Answer 3

Chronic HTN and. Pregnancy -2022
Large, multicent RCT
Assess intensive BP control in pregnancy
=> improved maternal and fetal outcomes when initiated treatment at >140/90

Question 4

What is target BP based on ADA and CHIPS study in diabetic nephropathy + pregnant women

Answer 4

Control of HTN in Pregnancy Study
- target BP ~110-135/85

Question 5

First line antihypertensives in pregnancy

Answer 5

nifedipine
labetolol
alpha - methyldopa

-> in diabetics caution with labetalol d/t hypoglycemia risk

Question 6

are loop and thiazide diuretics safe in pregnancy?

Answer 6

yes but not first line -> only use if htn refractory to first line agents or sig vol overload (loops)

Question 7

risk of ACEi/ARBs in pregnancy

Answer 7

avoid esp in 2nd/3rd trimester
-congenital anomalies -> esp cardiovasc
-affect fetal kidney formation -> oligohydramnios and pulmonary hypoplasia

Question 8

what are maternal and fetal risks with uncontrolled BP

Answer 8

M: MI, stroke, spontaneous coronary artery dissection, worsening renal function, permpartum CM

F: growth restriction, stillbirth, preterm delivery, placental abruption