Blood pressure in pregnancy

Question 1

1st line for hypertension in pregnancy?

Answer 1

labetolol

Question 2

What is pre eclampsia?

Answer 2

condition seen after 20 weeks

Pregnancy induced hypertension AND proteinuria

Question 3

What does pre eclampsia predispose to?

Answer 3

IUGR, prematurity, eclampsia, haemorrhage, cardiac/multi organ failure

Question 4

What other features may be involved in severe pre eclampsia?

Answer 4

headache, visual disturbance, papilloedema, hyperreflexia

Question 5

What is HELLP?

Answer 5

haemolysis, elevated liver enzymes and low platelet count

Question 6

Which women are at high risk and should therefore be taking aspirin?

Answer 6

hypertensive disease during a previous pregnancy
chronic kidney disease
autoimmune disease such as systemic lupus erythematosis or antiphospholipid syndrome
type 1 or type 2 diabetes
chronic hypertension.

Question 7

If women have 2 or more moderate risk factors for hypertension, they should take aspirin. List these factors.

Answer 7

first pregnancy
age 40 years or older
pregnancy interval of more than 10 years
body mass index (BMI) of 35 kg/m2 or more at first visit
family history of pre-eclampsia
multiple pregnancy.

Question 8

Which antihypertensives should be switched in women with chronic hypertension when they become pregnant?

Answer 8

ace inhibitors/ARBS

chlorothiazide

Question 9

Women with what level of hypertension should be admitted to hospital?

Answer 9

160 systolic or above

Question 10

Women with what level of hypertension AND proteinuria should be admitted to hospital

Answer 10

140 systolic

Question 11

If a woman in a critical care setting who has severe hypertension or severe pre-eclampsia has or previously had an eclamptic fit, what should be given?

Answer 11

IV Magnesium sulphate

Question 12

What other antihypertensives may be used in pregnancy?

Answer 12

nifedipine

hydralazine