HTN in preg / Pre-eclampsia Flashcards
what % of preg have HTN
8
define HTN in preg
> 140 systolic or >90 diastolic on 2 occasions, 6hrs apart
define proteinuria
300mg + in 24hrs
define pre induced HTN
HTN after 20 weeks into preg without proteinuria
define pre-eclampsia
HTN after 20 weeks into preg, with proteinuria, which all resolves within 6wks PP
define chronic HTN
HTN before 20 weeks of preg, and still present 6 weeks PP
aetiology of pre eclampsia
immune maladaptation, placental ischaemia, oxidative stress, genetic susceptibility
RFs of pre-eclampsia
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
why do primips have higher risk of pre eclampsia
immune response to paternal Ags in foetus causing vasospasm and HTN
what type of pre-eclampsia is more severe
early onset
any Sx
foetal manifestations due to placental insufficiency
describe morbidity of pre-eclampsia
1/3 of all maternal morbidity / mortality
major cause of mortality
5% stillbirths
50% have pre term babies
PC of pre-eclampsia
headache
flashing lights / blurry vision
epigastric / RUQ pain
oedema - hands, feet, face
N&V
reduced foetal movements
suspicion of small baby
what causes eye Sx in pre-eclampsia
papilloedema
what causes reduced foetal movements in pre-eclampsia
placental insufficiency
signs of pre-eclampsia
papilloedema
brisk reflexes
ankle clonus
non dependent oedema
epigastric / RUQ tenderness
IUGR
abruption
IUD
complication of pre-eclampsia causing abdo pain
subscapular haemorrhage
hepatitis
bloods & results for pre-eclampsia
FBC - thrombocytopenia
LFTs - raised transaminases
RFTs - abnormal U&Es, high urate
film - haemolysis
complications of pre-eclampsia
stroke
eclampsia
cerebral haemorrhage
pulmonary oedema
liver failure
subscapular haemorrhage
HELLP syndrome
abruption
acute renal failure
DIC
IUGR / prem
long term complications of pre-eclampsia
reoccurrence
CVD risk - MI / TIA / ischaemia
what does eclampsia look like
seizures
(all seizures in preg are eclampsia until proven otherwise)
pre Mx of pre-eclampsia
aspirin
Mx of HTN of pre-eclampsia
labetalol
nifedipine
hydralazine
methyldopa
Mx of seizures of pre-eclampsia
MgSO4
how is pre-eclampsia screened for
BP and proteinuria
Hx
Uterine artery doppler - notching & increased diastolic resistance
