Exam 2- Hypertensive disorders of pregnancy Flashcards
Hypertension disorders is more prevalent as?
as age and weight increases
Categories of hypertensive disorders
- Chronic Hypertension
- Gestational Hypertension
*Preeclampsia/Eclampsia/HELLP - Chronic hypertension with superimposed
preeclampsia
what is considered chronic hypertension?
Blood pressure exceeding 140/90 before pregnancy
or before 20 weeks gestation.
gestation hypertensive?
- Onset after 20 weeks
- Resolving 12 weeks postpartum
- Without proteinuria**
- BP greater than 140/90
PRE-ECLAMPSIA
Hypertension + proteinuria develop after 20
weeks of gestation
systemic wide
PRE-ECLAMPSIA : categorized as
- Categorized as mild or severe
- Remains one the leading causes of death and severe
maternal morbidity worldwide.
PRE-ECLAMPSIA : may be accompanied by
May be accompanied by maternal organ dysfunction
of cardiovascular, hepatic, renal, and central
nervous system (CNS).
PRE-ECLAMPSIA: etiology
- Unique to human pregnancy
- Cause is unknown
- Theories exist to try to explain etiology
PRE-ECLAMPSIA: patho
- Progressive multisystem disorder results from abnormal
placental plantation and a maternal vascular response.
Abnormal development of blood vessels in placenta
- All result in placental ischemia. (Decreased placental
perfusion and hypoxia)
PATHO-PLACENTAL ISCHEMIA &
VASOSPASM
Placental ischemia
- Cells of placenta aren’t getting
enough oxygen (Poor tissue perfusion in all
organ systems)
- Release of inflammatory molecules
that are toxic to endothelial cells.
- Endothelial cell dysfunction caused
by placental ischemia.
- This anomaly causes generalized
vasospasm.
*All leading to signs and symptoms of
preeclampsia.
Pre-eclampsia: PATHO-SIGNS AND SYMPTOMS
- Vessels lose
ability to
control tone
and relax-
increased
BP - Increased
permeability
and capillary
leakage
Pre-eclampsia patho: Kidney function
- Kidney function (increased
permeability and capillary
leakage) leak protein; proteinuria Kidney
(vasospasm) serum uric acid increases
Pre-eclampsia patho: other blood vessel leak where? causing what?
Other blood vessels leak into
tissue (remember water follows
protein)-edema/generalized
Pre-eclampsia patho: dysfunction of vessels in brain causes what symptoms?
Dysfunction of vessels in brain;
cerebral edema and cortical
brain spasm-CNS irritability-HA,
hyper-reflexia, seizures(eclampsia)
Pre-eclampsia patho: Liver dysfunction (ischemia) causes what symptoms?
- Liver dysfunction (ischemia):
elevated enzymes-AST, ALT,
epigastric pain, N/V
