HTN

Question 1

Def chronic HTN

Answer 1

1. HTN before preg
2. HTN before 20w
3. HTN till 12w after labor

Question 2

Chronic HTN diagnosis criteria

Rx

Answer 2

Mild: 140-160 / 90-110
Severe: > 160 / > 110

Use drug if severe
Labetalol

Question 3

Def PIH

Answer 3

HTN after 20w

WO proteinuria

Question 4

Def pre-eclampsia

Answer 4

HTN after 20w

With proteinuria

Question 5

Mild Pre-eclampsia diagnosis criteria

Answer 5

1. > 140 / > 90 after 20w

2. Proteinuria > 300 mg in 24h urine / 2 times 1+ dipstick with 6h interval

Question 6

Severe Pre-eclampsia diagnosis criteria

Rx

Answer 6

1. > 160 / > 110 2times with 4h interval
If HTN stays steady more than 15min start Rx
2. Kidney: Cr raise > 1.1 OR 2x Cr
3. Liver: RUQ pain
4. Liver: 2x LFT
5. Cerebral: headache, scotoma
6. Lung: edema
7. Thrombocytopenia < 100k

Labor

Question 7

Def HELLP

Answer 7

1. Haemorrhage
2. Elevated liver test
3. Low platelet

Question 8

Mild Pre-eclampsia Rx

Answer 8

Term
Labor

Preterm
درمان انتظاری
1. Rest
2. US for IUGR/Oligohydramnios 
Every 3w
3. CBC, LFT, BUN/Cr, UA
Every w
4. NST, BPP
2x a week
5. Fetal movement
Daily

Question 9

Severe Pre-eclampsia Rx

Answer 9

1. If > 34w labor
2. Magnesium sulphate and anti HTN
3. CS if < 37
4. Daily monitor of mom and baby