Genital and Urinary System Disorders (FEMALE)- Notes from Slideshow (Quiz 4) PART 2 Flashcards
Pregnancy Complications
- Preeclampsia
- Eclampsia
- HELLP
- Mastitis
A potentially dangerous pregnancy complication characterized by high blood pressure.
Preeclampsia
Preeclampsia Symptoms
- May be no symptoms
- HTN
- proteinuria
- edema
Who gets Preeclampsia
- nulliparous women
- over 35
- 3rd trimester
Result of Preeclampsia
resolves with delivery
Severity of Preeclampsia
Can result in fatal complications
Management of Preeclampsia
Medications until baby is mature enough to be delivered
Moral dilemma of Preeclampsia
Weighing risks/benefits:
- Early delivery
- Continued pre-eclampsia symptoms
Preeclampsia classic triad
- P: Proteinuria
- R: Rising BP
- E: Edema
How is Proteinuria in Preeclampsia diagnosed
-> 300mg/24hr
- (protein : creatine ratio)
>or = 0.3
-(dipstick reading) 1+
Does absence of Proteinuria on less accurate tests rule out Preeclampsia?
no
Which tests are considered less accurate Proteinuria tests?
- urine dipstick
- routine urinalysis
Onset of rising BP in Preeclampsia?
- Usually sudden onset
- Can develop slowly too
Diagnosis of high BP in Preeclampsia
- > or = 140/90 mmHg
- documented on two occasions (at least 4 hours apart)
Edema in Preeclampsia
- sudden weight gain/swelling
- pitting edema
Where is edema typically found in Preeclampsia?
- face
- hands/feet
Severe complication of preeclampsia
Eclampsia
Symptoms of Eclampsia
- Seizures/convulsions
- Impaired renal function
- Worse HTN
Resolution of Eclampsia
Resolves with delivery
Common feature of Eclampsia
- insufficient maternal blood flow to the placenta
- d/t inadequate remodeling of the spiral arteries of the uteroplacental vascular bed
Potential serious complication of Eclampsia
- end organ failure
- HELLP syndrome
HELLP syndrome
H: Hemolysis E: Elevated L: Liver L: Low P: Platelets
Hemolysis, Elevated Liver (Enzymes), Low Platelets
HELLP syndrome is a complication of what?
pre-eclampsia/eclampsia
Who gets HELLP?
- multiparous women
- age 25+
- PMH of poor pregnancy outcomes
Complication of HELLP
full blown disseminated intravascular coagulation (DIC)
Cause of HELLP
Believed to result from:
- microvascular endothelial activation
- cell injury
- Abnormal placental development/function
- Immune intolerance of placenta
- Lesions on membrane b/w maternal/fetal circulation
- Release of inflammatories from placenta to circulation
- Systemic inflammatory response
- Microvascular damage
- RBC damage
- Platelet aggregation (low platelets seen on CBC)
- Microthrombin in hepatic circulation
- MAHA (anemia)
- damage to hepatocytes
- HELLP
Pathophysiology of HELLP: first cause
Pathophysiology of HELLP: first cause
- Abnormal placental development/function
- Immune intolerance of placenta
- Lesions on membrane b/w maternal/fetal circulation
- Release of inflammatories from placenta to circulation
- Systemic inflammatory response
- Microvascular damage
- RBC damage
- Platelet aggregation (low platelets seen on CBC)
- Microthrombin in hepatic circulation
- MAHA (anemia)
- damage to hepatocytes
- HELLP
- More than one form of FasL/receptor gene (Protein in T cells that signal target cell death)
- Increases levels of placental FasL in maternal circulation
- damage to hepatocytes
- HELLP
Pathophysiology of HELLP: second cause
Pathophysiology of HELLP: second cause
- More than one form of FasL/receptor gene (Protein in T cells that signal target cell death)
- Increases levels of placental FasL in maternal circulation
- damage to hepatocytes
- HELLP
Infection of the breast
Mastitis
Who most commonly gets Mastitis
breastfeeding women
- Acute breast pain
- Nipple irritation
- Hormonal changes
- Typically unilateral
- Fever
- Warm, erythematous, inflamed breast
Symptoms of Mastitis
Symptoms of Mastitis
- Acute breast pain
- Nipple irritation
- Hormonal changes
- Typically unilateral
- Fever
- Warm, erythematous, inflamed breast
Red
erythematous
Most common cause of Mastitis
Staph. Aureus
