Complications of pregnancy 2 Flashcards
What are the complications of hypertensive disorders during pregnancy?
Maternal:
- Eclampsia seizures
- Cerebral haemorrhage or stroke
- Haemolysis
- Elevated liver enzymes
- Low platelets
- Renal failure
- Pulmonary oedema
Fetal:
- Impaired placental perfusion leading to fetal distress or prematurity
What are the complications associated with diabetes in pregnancy?
- Macrosomia & polyhydramnios
- Miscarriage
- Shoulder dystocia
- Stillbirth
- Pre-eclampsia
When should thrombosis in pregnancy be suspected?
1) Older mothers
2) Increased BMI and a smoker
3) Pre-eclampsia
4) Decreased mobility
What is chronic hypertension in pregnancy?
Hypertension pre-pregnancy or at booking (<21 weeks gestation)
What is the systolic pressure for mild hypertension?
140-149
What is the systolic pressure for moderate hypertension?
150-159
What is the systolic pressure for severe hypertension?
> 160
How is gestational hypertension defined?
Hypertension which develops after 20 weeks gestation
What is the definition of pre-eclampsia?
New hypertension after 20 weeks associated with proteinuria
In which population of mothers is chronic hypertension most common?
Older mothers
If a pregnant woman is identified as having chronic hypertension what medication should she be started on?
Labetolol - 1st
Nifedipine - 2nd
Methyldopa
What is the target blood pressure for pregnant woman?
< 150/100
What antihypertensive medications should not be used during pregnancy?
ACE-inhibitors
ARB’s
What other steps can mothers take to lower their BP, apart from medication?
Lower dietary Sodium
How much protein must be detected in urine for pre-eclampsia to be diagnosed?
300mgs in 24 hours
Protein/creatinine ratio > 0.3
What is the pathophysiological process involved in pre-eclampsia?
1 - Secondary invasion of maternal spiral arterioles by trophoblasts resulting in reduced placental perfusion
2 - Imbalance between vasodilators and vasoconstrictors