Hypertension and Pre-Eclampsia

Question 1

After what gestation date does gestational hypertension occur?

Answer 1

Post 20 weeks

Question 2

What is the grading of gestational hypertesnion?

Answer 2

Mild: 140-149/90-99 mmHg

Moderate: 150-259/100-109 mmHg

Severe: >160/100mmHg

Question 3

What is the management of mild gestational hypertension?

Answer 3

Regular BP monitoring (twice weekly) and check urine for protein at each visit. Counsel patient on signs of pre-eclampsia.

Question 4

What is management of moderate gestational hypertension?

Answer 4

Labetalol + regular monitoring.

Question 5

What is the management of severe gestational hypertension?

Answer 5

Admit + labetalol + regular monitoring.

Question 6

What are the potential complications of gestational hypertension?

Answer 6

Pre-eclampsia, eclampsia, placental abruption, impaired foetal growth, premature birth.

Question 7

What are the features of pre-eclampsia?

Answer 7

Hypertension (>140/90) and proteinuria).

+/- oedema, headache, visual disturbance, epigastric pain, vomiting, low platelets, raised LFTs

Question 8

What are the features of HELLP?

Answer 8

Haemolysis, elevated liver enzymes, low platelets.

Question 9

What is the management for all women with pre-eclampsia?

Answer 9

ADMIT. Frequent bloods, urine collection, foetal monitoring.

Labetalol if BP >150/100

Question 10

What is the protocol for delivery in pre-eclampsia?

Answer 10

<34 weeks: give steroids, then reassess after 24 hours.

> 34 weeks: delivery

If unstable, deliver ASAP at any age.

Question 11

What is the management of eclampsia?

Answer 11

ABCDE (airway, O2)
Magnesium for seizures
IV labetalol
Monitor fluids

Delivery (usually by LSCS) as soon as stable