Disorders Of Pregnancy Pre Eclampsia

Question 1

Pre eclampsia

Answer 1

A disorder of pregnancy with new onset hypertension

Question 2

Diagnosis

Answer 2

New onset hypertension greater than 140/90
Reduced fetal movement or amniotic fluid volume
Oedema
Headache
Abdominal pain
Visual disturbance seizures and breathlessness
Occurs after 20 weeks

Question 3

Subtypes

Answer 3

Early onset <34 week’s associated with fetal and maternal symptoms

Late onset >34 weeks more common. Lately maternal symptom fetus generally ok less placental changes

Question 4

Risk factors

Answer 4

BMI
Family history
Increased maternal age
Gestational hypertension
Diabetes,PCOS,renal disease,sub fertility

Question 5

Risks to fetus and mother

Answer 5

Mother- damage to kidneys liver brain and organ,possible seizure
Placental abruption
Fetus- reduced growth,preterm birth,pregnancy

Question 6

Placenta, defects

Answer 6

Caused when evt invasion of maternal spiral arteries is limited to deciduous layers. Spiral arteries aren’t remodelled thus perfusion restricted

Question 7

Placental growth factor and FLT1

Answer 7

PLGF is pro angiogenic and released in large amounts by placenta
FLT1 binds to angiogenic factors making them less available
In pre eclampsia FLT1 released in excess reducing availability of pro angiogenic factors

Question 8

Management

Answer 8

Can only be resolved by placental deliver
If less than 34 weeks then it’s preferred to try and maintain the pregnancy. If greater than 37 weeks delivery is preferred
Corticosteroids are given if less than 34 weeks pregnant to promote fetal lung development

Question 9

Prevention

Answer 9

Weight loss
Exercise during pregnancy
Low does aspirin for at risk groups