Blood pressure in pregnancy Flashcards
Blood pressure < 24 weeks
Drops due to decrease in vascular resistance
Blood pressure > 24 weeks
increases back to normal levels until delivery due to increase in stroke volume
Blood pressure after delivery
May peak again 3 -4 days post partum
How should blood pressure be measured?
- Sitting / supine in left sided tilt to avoid compression of IVC - low bp
Pregnancy induced hypertension
Hypertension > 140/90 in the second half of pregnancy in the absence of proteinuria
Pregnancy induced hpt increases the risk of ;
- Pre eclampsia
2. Early on set hypertension
Pregnancy induced hypertension returns to normal at..
within 6 weeks of delivery
Chronic hypertension
High BP 140/90 at the booking visit
Post partum hypertension
New hypertension may arise in the post-partum period
Differentials for post partum hypertension
- Physiological hpt
- Pre existing chronic hpt
- New onset pre eclampsia
( BP peaks on 3rd/5th day of post partum )
Principles of hypertension in pregnancy
- aim for BP levels not <120/80
2. Does not protect against pre eclampsia
Ant hypertensive treatments in pregnancy
- Labetalol
- Methyldopa
- Nifedipine
- Hydralazine
- Atenalol
- Ace inhibitors
Labetalol - principles of treatment / Atenallol
- Avoid in asthma
2. Okay for breast feeding
Methyldopa
- Alpha 2 adrenergic agonist
- Risk of depression and should be changed post natally
- Okay to breast feed
Nifedipine
- calcium channel blocker
2. okay to breastfeed
