high risk pregnancy - hypertensive disorders

Question 1

what are the classifications of hypertension in pregnant women ?

Answer 1

pregnancy induced hypertension
pregnancy aggravated hypertension
coincidental hypertension

Question 2

what are the types of pregnancy induced hypertension ?

Answer 2

gestational hypertension
pre-eclampsia
eclampsia

Question 3

what are examples of pregnancy aggravated hypertension ?

Answer 3

superimposed pre-eclampsia and eclampsia

Question 4

what is the effect of chronic hypertension on the placenta and the baby ?

Answer 4

chronic hypertension is associated with placental insufficiency causing fetal growth retardation and oligohydraminous

Question 5

what is the management of mild cases of coincidental hypertension ?

Answer 5

usually no treatment and just follow up

Question 6

what is the management of moderate and severe cases of coincidental hypertension ?

Answer 6

anti hypertensive drug therapy
diuretics
salt restriction and assessment of fetal growth

Question 7

what kind of anti hypertensive drug is contraindicated in pregnancy ?

Answer 7

ACE inhibitors

Question 8

how should superimposed pre eclampsia be managed ?

Answer 8

managed as pre eclampsia

Question 9

what is gestational hypertension ?

Answer 9

hypertension occurring after the 20th week of pregnancy

Question 10

what is the criteria for diagnosing pre eclampsia ?

Answer 10

1. sustained elevation of the BP to 140/90 mHg or more on two occasions 4 hours apart
2. proteinuria

Question 11

what is the criteria to diagnose eclampsia ?

Answer 11

features of pre eclampsia along with grand mal seizures

Question 12

how do you diagnose chronic hypertension ?

Answer 12

hypertension alone diagnosed before pregnancy or before 20 weeks of gestation

Question 13

how do you diagnose superimposed PE ?

Answer 13

pre eclampsia on top of chronic hypertension

Question 14

at what level can we say that this is a hypertensive pregnant woman ?

Answer 14

above 140/90

Question 15

what value qualifies as severe hypertension ?

Answer 15

more than 160/110

Question 16

what can be given to women that are at a high risk of becoming hypertensive ?

Answer 16

aspirin for prevention

Question 17

what medication can be given for the treatment of hypertension in pregnancy ?

Answer 17

labetalol, nifedipine, methyldopa, doxasozin

Question 18

in the diagnosis of pre eclampsia if there is no proteinuria what other sign can be used to diagnose pre eclampsia ?

Answer 18

recent organ dysfunction manifested by one or more of the following :
thrombocytopenia 
elevated serum liver transaminases 
rising serum creatinine 
CNS symptoms
DIC 
Pulmonary oedema

Question 19

what is the most appropriate management plan for eclampsia ?

Answer 19

use of magnesium sulphate to stop fits
use anti hypertensives to control BP
deliver the foetus once the mother is stabilized

Question 20

during follow up of a patient who is at high risk of pre eclampsia what investigations should be done ?

Answer 20

US

doppler

Question 21

who is at a higher risk at developing pre eclampsia ?

Answer 21

previous pre-eclampsia
underlying medical condition
multiple pregnancy