Hypertension

Question 1

Define hypertension

Answer 1

2 reading > 140/90 (4 hrs apart)
OR
1 reading > /110

Question 2

What are the classifications of hypertension (define them)?

Answer 2

Mild= 140-149/90-99
Moderate= 150-159/100-109
Severe= >160/>110

Question 3

What are the different types of hypertension (define them)?

Answer 3

Chronic= predates pregnancy/before 20 weeks 
Gestational= after 20 weeks without proteinuria
Pre-eclampsia= after 20 weeks with proteinuria

Question 4

What are the risk factors for pre-eclampsia?

Answer 4

1st Pregnancy, change of partner, Hx, BP> /80, BMI>30, multiples

Question 5

What are some symptoms of pre-eclampsia?

Answer 5

New hypertension, proteinuria, visual disturbance, headache, epigastric pain, oedema

Question 6

What antenatal care is offered to women with pre-eclampsia?

Answer 6

Early referral and 75 mg aspirin

Question 7

What are some maternal complications of pre-eclampsia?

Answer 7

Intracranial haemorrhage, placenta abruption, eclampsia, RDS

Question 8

What are some fetal complications of pre-eclampsia?

Answer 8

FGR, Oligohydramnios, Hypoxia, placenta abruption, preterm delivery

Question 9

What are the blood signs of pre-eclampsia?

Answer 9

Increased: Haemoglobin, haemotocrit and uric acid
Decreased: Plasma volume, platelets, urates

Question 10

What is the dosage of labetalol?

Answer 10

200 mg
Maintance= 200mg tads
Bolus= 50 mg IV over 5 mins

Question 11

Evaluate labetalol

Answer 11

Drops BP within 30 mins
Increased risk of IUGR
Increased risk of neonatal hypoglycemia

Question 12

What is the dosage of nifedipine?

Answer 12

10 mg orally every 30 mins until 30 mg given

Question 13

Evaluate nifedipine

Answer 13

Constipation, malaise, oedema, vasodilation

Question 14

What is the dosage of hydralazine?

Answer 14

Bolus of 5mg over 15 mins
Further 5 mg if Bp > 160/
Maintenance= 5ml/hr

Question 15

Evaluate hydralazine

Answer 15

Increased risk of neonatal thrombocytopenia
Diarrhea
Dizziness

Question 16

How do you manage eclampsia?

Answer 16

Hourly obs, neuro obs, continuous FHR, ECG, CVP, urgent bloods, restrict fluids

Question 17

What is the postnatal care for women with hypertension?

Answer 17

BP checks day 3-6 and continue anti-hypertension

Question 18

Can antihypertensive medication been taken during breastfeeding?

Answer 18

Yes the amount is too small to cause an effect

Question 19

What is the midwifes role in looking after women with hypertension?

Answer 19

Compare BP, urinalysis, manual BP and documentation