HTN Disorders In Pregnancy Flashcards
What are the maternal risks of chronic HTN?
MI, death, CVA, pulmonary edema, renal or liver failure, retinal ischemia and injury, preeclampsia/eclampsia
What are the fetal complications of chronic HTN?
Fetal growth restriction, preterm birth, placental abruption, stillbirth, neonatal death, congenital anomalies (heart defects, hypospadias, esophageal atresia)
What is chronic HTN?
Present before or recognized during firs half of pregnancy or persists after 12 weeks postpartum
What is gestational HTN?
Recognized after 20 weeks gestation
What is preeclampsia?
Occurs after 20 weeks gestation and coexists with proteinuria
What is eclampsia?
New onset seizure activity associated with preeclampsia
What is superimposed preeclampsia/eclampsia?
Transposed onto chronic HTN
How does preeclampsia affect the brain?
Causes HA due to cerebal edema; can result in fibrinoid necrosis, thrombosis, micro infarcts and petechial hemorrhages
How does preeclampsia affect the heart?
Causes edema due to absence of normal intravascular volume expansion (third spacing); reduction in circulating blood volume (false increase in H&H)
How does preeclampsia affect the lungs?
Causes non cardiogenic pulmonary edema; changes in colloid osmotic pressure, capillary endothelial integrity and intravascular hydrostatic vessels (leaking vessels)
How does preeclampsia affect the liver?
Causes RUQ; sinusoidal fibrin deposition in the peri portal areas with surrounding hemorrhage and portal capillary thrombi (subcapsular hematoma —> liver rupture); stretching of glisson’s capsule results in RUQ pain
How does preeclampsia affect the kidneys?
Causes proteinuria/edema; swelling and enlargement of glomerular capillary endothelial cells; narrowing of the capillary lumen
How does preeclampsia affect the eyes?
Can cause vision changes; retinal vasospasm and retinal edema
