HTN in preg / Pre-eclampsia Flashcards

1
Q

what % of preg have HTN

A

8

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2
Q

define HTN in preg

A

> 140 systolic or >90 diastolic on 2 occasions, 6hrs apart

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3
Q

define proteinuria

A

300mg + in 24hrs

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4
Q

define pre induced HTN

A

HTN after 20 weeks into preg without proteinuria

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5
Q

define pre-eclampsia

A

HTN after 20 weeks into preg, with proteinuria, which all resolves within 6wks PP

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6
Q

define chronic HTN

A

HTN before 20 weeks of preg, and still present 6 weeks PP

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7
Q

aetiology of pre eclampsia

A

immune maladaptation, placental ischaemia, oxidative stress, genetic susceptibility

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8
Q

RFs of pre-eclampsia

A

para 0
<18 or >35 y/o
BMI >35
black
prev pre-eclampsia
FH pre-eclampsia
PMH renal disease, HTN, DM, AI, APLS
multi preg

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9
Q

why do primips have higher risk of pre eclampsia

A

immune response to paternal Ags in foetus causing vasospasm and HTN

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10
Q

what type of pre-eclampsia is more severe

A

early onset
any Sx
foetal manifestations due to placental insufficiency

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11
Q

describe morbidity of pre-eclampsia

A

1/3 of all maternal morbidity / mortality
major cause of mortality
5% stillbirths
50% have pre term babies

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12
Q

PC of pre-eclampsia

A

headache
flashing lights / blurry vision
epigastric / RUQ pain
oedema - hands, feet, face
N&V
reduced foetal movements
suspicion of small baby

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13
Q

what causes eye Sx in pre-eclampsia

A

papilloedema

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14
Q

what causes reduced foetal movements in pre-eclampsia

A

placental insufficiency

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15
Q

signs of pre-eclampsia

A

papilloedema
brisk reflexes
ankle clonus
non dependent oedema
epigastric / RUQ tenderness
IUGR
abruption
IUD

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16
Q

complication of pre-eclampsia causing abdo pain

A

subscapular haemorrhage
hepatitis

17
Q

bloods & results for pre-eclampsia

A

FBC - thrombocytopenia
LFTs - raised transaminases
RFTs - abnormal U&Es, high urate
film - haemolysis

18
Q

complications of pre-eclampsia

A

stroke
eclampsia
cerebral haemorrhage
pulmonary oedema
liver failure
subscapular haemorrhage
HELLP syndrome
abruption
acute renal failure
DIC
IUGR / prem

19
Q

long term complications of pre-eclampsia

A

reoccurrence
CVD risk - MI / TIA / ischaemia

20
Q

what does eclampsia look like

A

seizures
(all seizures in preg are eclampsia until proven otherwise)

21
Q

pre Mx of pre-eclampsia

A

aspirin

22
Q

Mx of HTN of pre-eclampsia

A

labetalol
nifedipine
hydralazine
methyldopa

23
Q

Mx of seizures of pre-eclampsia

A

MgSO4

24
Q

how is pre-eclampsia screened for

A

BP and proteinuria
Hx
Uterine artery doppler - notching & increased diastolic resistance