Eclampsia and Hypertension in Pregnancy Flashcards
in normal placentation what does the trophoblast invade
invades the myometrium and the spiral arteries of the uterus, destroying the tunica muscualris media
what are the moderate risk factors of pre-eclampsia
nuliparity maternal age>40 years maternal BMI>35 at initial presentation fam history pregnancy interval >10 years multiple pregnancy
high risk factors for pre-eclampsia
chronic hypertension HTN, pre-eclampsia previously pre-existing chronic kidney disease DM autoimmune diseases eg SLE, antiphospholipid syndrome
what is the diagnostic criteria for pre-eclampsia
hypertension (systolic >140mmHg or diastolic >90) on 2 occasions >4 hours apart
significant proteinuria >300mg protein in a 24 hour urine sample or >30mm/mol
in a woman greater than 20 weeks gestation
if there are any clinical symptoms what does pre-eclampsia present with
headache-usually frontal visual disturbances-eg blurred or double vision, halos, flashing lights epigastric pain sudden onset non-dependent oedema hyper-reflexia
what are the major fetal complications of pre-eclampsia
prematurity, IUGR, placental abruption and intrauterine death
what can placental abruption lead to for the mother
DIC
how does methyldopa work
it is an alpha agonist
what is placental abruption
rupture of maternal vessels within the BASAL layer of the endometrium
what are the 2 types of placental abruption
revealed and concealed
describe revealed placental abruption
bleeding tracks down from the sit of placental separation and drains through the cervix causing vaginal bleeding
what is concealed placental abruption
bleeding remains within the uterus and typically forms a clot retroplacentally
how does placental abruption usually present
with PIANFUL vaginal bleeding, uterus may be woody and painful on palpation
in a normal pregnancy what maintains endothelial health
VEGF and TGF-B1
complications (pre-eclampsia) are due to what
endothelial dysfunction
