Hypertension and Pre-eclampsia

Question 1

what is hypertension in pregnancy defined as?

Answer 1

> 140/90 on 2 occasions
160/110mmHg once
raised >30/15mmHg since 1st trimester

Question 2

types of hypertension in pregnnacy

Answer 2

pre-existing
pregnancy induced
pre-eclampsia

Question 3

when does PIH happen?

Answer 3

2nd trimester and should resolve around 6 weeks after delivery

Question 4

what distinguishes pre-eclampsia?

Answer 4

> 20th week
oedema
proteinuria >0.3

Question 5

classification of PET

Answer 5

1. early <34 weeks

2. late >34 weeks

Question 6

presentation of PET

Answer 6

headache
N&V
epigastric and RUQ pain
visual disturbance/ flashing lights
leg swelling

Question 7

systemic presentations of PET

Answer 7

liver disease - HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)
placental disease

Question 8

cerebral irritation indications

Answer 8

brisk reflexes
confused
restlessness

Question 9

what does brisk reflexes increase risk of?

Answer 9

seizure

Question 10

surveillance of PET

Answer 10

CTG
BP
urinalysis
protein/ creatinine ratio
FBC
U&Es
G&C
LFTs

Question 11

prevention of PET

Answer 11

aspirin 12-36 weeks

Question 12

management of PET

Answer 12

labetalol or nifedipine
methyldopa
hydralazine
doxazocin

Question 13

CI to labetalol

Answer 13

asthma

Question 14

CI to methyldopa

Answer 14

depression

hepatic dysfunction

Question 15

aim of BP

Answer 15

130/80

Question 16

CI to doxazosin?

Answer 16

breast feeding

Question 17

what to avoid in PET (Drug-wise)

Answer 17

diuretics
ACEI
ergometrine

Question 18

what is eclampsia?

Answer 18

tonic-clonic seizure occurring with features of pre-eclampsia

Question 19

management of eclampsia

Answer 19

IV labetolol, IV hydralazine
magnesium sulphate (or BZDs)
fluid restrict if pulmonary oedema
delivery

Question 20

how to reverse magnesium sulphate?

Answer 20

calcium gluconate