complications in pregnancy 2

Question 1

What is the blood pressure range for mild hypertension in pregnancy

Answer 1

Systolic - 140-149
Diastolic - 90-99

Question 2

What is the blood pressure range for moderate hypertension in pregnancy

Answer 2

Systolic - 150-159
Diastolic - 100-109

Question 3

What is the blood pressure range for severe hypertension in pregnancy

Answer 3

Systolic - greater than or equal to 160
Diastolic - greater than or equal to 110

Question 4

What is chronic hypertension in pregnancy

Answer 4

Hypertension pregnancy or less than 20 weeks gestation

Question 5

What is gestational hypertension

Answer 5

New hypertension in pregnancy after 20 weeks gestation

Question 6

What is preeclampsia

Answer 6

Hypertension after 20 weeks gestation which is associated with significant proteinuria

Question 7

What values in investigation are definitive for proteinuria

Answer 7

> 1+ protein on dip stick
Urinary protein- creatinine ratio >30 mg/mmol

24 hour urine protein collection >300mg/day

Question 8

What is the definition of pre-eclampsia

Answer 8

Hypertension on two occasions more than 4 hours apart with proteinuria of more than 300mg/24 hours

Question 9

What are the risk factors for developing pre-eclampsia

Answer 9

first pregnancy
older age
pre-eclampsia in last pregnancy
Pregnancy interval > 10 years
BMI >35
chronic hypertension, renal disease or diabetes
SLE (lupus)

Question 10

What are the symptoms of pre-eclampsia

Answer 10

Headache
blurring vision
Epigastric pain
Pain below the ribs
vomiting
sudden swelling of hands, face and legs
Proteinuria >3+
reduced urine output
convulsions (eclampsia)

Question 11

What is the management of pre-eclampsia

Answer 11

Delivering the baby is only cure but antihypertensives such as labetolol can be used as conservative treatment

Question 12

What is the treatment of the eclampsia (seizures) in pregnancy

Answer 12

Magnesium sulphate bolus + IV infusion

Question 13

What is the prophylaxis given for pre-eclampsia

Answer 13

Low does aspirin from 12 weeks to delivery

Question 14

Why is there a higher insulin requirement for a pregnant mother

Answer 14

Human placental lactogen, progesterone, human chorionic gonadotropin and cortisol from the placenta have an anti-insulin effect

Question 15

Why can macrosomia occur in diabetic mothers

Answer 15

The maternal glucose crosses the placenta and induces increased insulin release in the foetus which causes macrosomia

Question 16

What are the risk factors for developing gestational diabetes

Answer 16

BMI >30
previous macrosomic baby >4.5kg
Family history of diabetes

Question 17

Why are pregnant women more susceptible to thrombus

Answer 17

Pregnancy is a hypercoaguable state:
- Increase in fibrinogen factor VIII
- Decrease in natural anticoagulants (antithrombin III)
- Decrease in fibrinolysis

Question 18

What are the signs and symptoms of venous thrombo-embolism in pregnancy

Answer 18

Pain in calf, increased girth of affected leg, calf muscle tenderness, breathlessness, pain on breathing, cough, tachycardia, hypoxic, pleural rub …