B8.018 High Risk Pregnancies Flashcards
symptoms concerning for preeclampsia
headache visual disturbances neuro deficits chest pain/ dyspnea N/V RUQ pain
why are the above symptoms associated with HTN/ preeclampsia?
swelling/vasoconstriction within in the brain
-posterior reversible encephalopathy syndrome (PRES)
most serious complication of preeclampsia
stroke
mostly hemorrhagic and preceded by severe headache and severe and fluctuating blood pressure levels
def of HTN in pregnant mother
SBP >140
DBP >90
2 separate occasions, 4 hours apart
hyperreflexion as a symptom of HTN
associated with intracranial hypertension
fundoscopic exam in HTN
constriction or spasm of retinal arterioles
if severe: changes associated with hypertensive retinopathy may occur
why is there proteinuria with preeclampsia
impaired integrity of glomerular filtration barrier and altered tubular handling of filtered proteins (hypofiltration) leading to increased protein excretion
why is serum Cr elevated in preeclampsia
severe end of a disease spectrum
AKI
normal Cr changes in pregnancy
physiologic increase in GFR during normal pregnancy results in decrease in serum Cr concentration
why thrombocytopenia in preeclampsia
microangiopathic endothelial injury and activation result in formation of platelet and fibrin thrombi in the microvasculature
accelerated platelet consumption leads to thrombocytopenia
why hemolysis in preeclampsia
vasoconstriction w microthrombi resulting in RBC destruction and schistocytes
hemoconcentration in preeclampsia
reduction of plasma volume due to capillary leaking
elevated hematocrit as a result
why are liver enzymes elevated in preeclampsia
reduced hepatic blood flow which results in ischemia and periportal hemorrhage
HELLP
hemolysis
elevated liver enzymes
low platelets
what is the source of trouble in HELLP syndrome?
the placenta!!
