Eclampsia Flashcards
what is transient hypertension (tHTN)
anxiety/white coat hypertension
exercise
>140/90
how to handle tHTN
if discovered, relax and recheck
if medicine patient, wait 2wks to recheck
if >20wks, get urinalysis to rule out proteinuria and keep a BP log
what is chronic hypertension (cHTN)
hypertension that predates the pregnancy
how is cHTN defined
> 140/90 before 20wks
how to handle cHTN
control blood pressure with α-methyldopa* - hydralazine or labetalol close follow-up - urinalysis for protein - ultrasound for IUGR
what is gestational hypertension (gHTN)
elevated BP after 20wks in absence of proteinuria or other systemic findings of preeclampsia
what is preeclampsia without severe features
elevated blood pressures >140/90
proteinuria >300mg/dL
what is PEC with severe features
any one:
- severe BP (>160/110)
- severe Proteinuria
- alarm symptoms
features and management of PEC without severe features
BP >140/90
onset after 20wks
proteinuria >300mg/dL
continue pregnancy until 37wks to deliver
features and management of PEC with severe features
any one of:
- BP >160/110
- Cr >1.1 or 2x baseline
- Plt <100
- increase AST or ALT 2x ULN
- RUQ or epigastric pain
- pulmonary edema
- headache or visual disturbance
magnesium and urgent delivery
how is eclampsia defined
seizure activity
how to treat hypertension
labetalol or hydralazine
when is magnesium indicated?
severe preeclampsia and eclampsia
when is magnesium given?
during labor and 24hrs after delivery
how magnesium works
can cause hypotension and relaxation of all nerves
magnesium tox
respiratory failure
loss of deep tendon reflexes
eventual cardiac arrest
reversal agent of magnesium toxicity
calcium
treating eclampsia spectrum: HTN
labetalol
hydralazine
treating eclampsia spectrum: magnesum
during labor and 24hrs p delivery
*mag checks
treating eclampsia spectrum: anti-epileptics
benzodiazepines to abort
magnesium
delivery
what is the cure for PEC-sPEC-EC?
delivery
treatment of PEC
control BP no magnesium delivery: - >37wks, elective - <37wks, observe
treatment of sPEC
control BP
magnesium
deliver urgently via induction
treatment of EC
control BP
magnesium
deliver emergently via section
why do seizures occur in eclampsia?
vasospasm and reperfusion
alarm symptoms that eclampsia may occur
capsular stretch, elevation of LFTs, decreased platelets
what is HELLP syndrome
hemolysis
elevated liver enzymes
low platelets
treatment of HELLP syndrome
magnesium
deliver emergently via section
symptoms of severe PEC
abdominal pain, swelling, blurry vision, scotomata, headaches, blurry vision, epigastric pain
