Complications of the Prenatal Period Flashcards
What are the classifications of HTN?
Chronic
Chronic with superimposed pre-eclampsia
Pre-eclampsia
Chronic HTN
BP> 140/90 mm Hg prior to 20 weeks gestation
Elevated BP persists after pregnancy
What are causes of chronic HTN?
Essential Hyperthyroidism Coarctation of the aorta Hyperaldosteroinism Cushings dz Connective tissue dz
What are maternal complications of chronic HTN?
CVA Renal disease Retinopathy Abruption Superimposed pre-eclampsia
What are fetal complications of chronic HTN?
IUGR- infrauterine growth restriction
Fetal death
What are the goals in therapy for chronic HTN?
maintain BP < 140/90 mm Hg -alpha-methyldopa -labetolol -nifedipine monitor fetal growth-US monitor for evidence of utero-placental insuff. -NST -biophysical profile
**NO ACE INHIB. OR ARBS
Pre-eclampsia
BP >140/90 after 20 weeks gestation
Proteinuria > 300 mg/24hr
Edema
What is the incidence of pre-eclampsia?
mild: 5-8%
severe: 0.6-1.2%
What are the maternal complications of pre-eclampsia?
CVA Eclampsia Acute renal failure Pulmonary edema Death
What are the fetal and neonatal complications of pre-eclampsia?
IUGR
Fetal death
Anemia, neutropenia and thrombocytopenia
What are the diagnostic criteria for severe pre-eclampsia?
BP> 160 or 110 mm Hg Proteinuria > 5g Oliguria <30ml/hr Increased DTRs Headache Visual changes Pulmonary edema RUQ pain Abnormal LFTs Thrombocytopenia IUGR
What do you do if a mother is experiencing characteristics of severe pre-eclampsia?
deliver that baby
What is the longest you wait to deliver a baby with severe or mild preclampsia at term?
48 hrs so you can give corticosteroids for fetal lumbar support
Do you deliver the baby if the mother has mild pre-clampsia and the baby is pre-term?
No, observe
Abruptio Placentae
premature separation of a normally implanted placenta
What is the frequency of abruptio placentae?
1%