Hypertension In Preg Flashcards
Preeclampsia is?
Syndromic Pregnancy induced HTN Proteinuria Generalized oedema Multi system dysfunctions
Preg HTN defined as?
> 140/90
Preeclampsia definition
HTN - >140/90 of 170/110
Proteinuria >300mg/24h
Generalised oedema
3 most important causes of proteinuria
Artifact-leukoruria from cervix
UTI
Preeclampsia
How to ask about preeclampsia to family?
Any difference in appearance? (Swollen face)
How to manage preeclampsia?
Premature delivery
How to cure preeclampsia?
Deliver the baby and placenta!
Preeclampsia affects What system?
Cardiovascular Renal Haematologic all Neurological Hepatic Uteroplacental
Symptoms for preeclampsia occurs?
LATE.
Very asymptomatic
Predisposing to preeclampsia?
FHx Age extremes First preg New paternity period of Sexual cohabitation (more antigen exposure) Assisted reproduction
Medical comorbidities that increase preeclampsia?
Chronic HTN SLE DM2 Disease Thrombophilias
Predisposing pregnancy conditions for preeclampsia?
Size of placenta from Multiple preg Gestational DM2 Trophoblasts disease Hydrops Fetalis
Trisomy13
Indicators of severe preeclampsia?
extreme HTN Headache Papillon edema Visual disturbance Upper Abdo pain Hyper reflexes Oliguria Proteinuria Thrombocytopaenia Pulmonary oedema Elevated liver enzymes
Management of HTN?
Admit Stabilize BP control Seizure prophylaxis Fluids Fetal welfare surveillance Multidisciplinary care DELIVERY Third stage management (drug to minimize bleeding - no longer ergometrine, now: -Syntocinon-) Postpartum observation Followup
Pre-eclampsia is cured when?
AFTER delivery. Not AT delivery, need postpartum observation
Post partum observation indicators
Look at urine output. If increasing:
Kidneys working, recovering,
Preeclampsia HTN management pharma?
Labetalol
Nifedipine
Neuronal stabilization in Preeclampsia pharma?
MgS04 syringe pump 4g bolus over 15 minutes
2g/HR maintenance
Monitor reflexes, Resp, serum levels, urine output
Continue 24 hours postpartum
The MAGPIE trial.
Antidote for MgS04 if the woman Preeclampsia stops breathing
CaCl2. 10ml, 10%
MgS04 effects in preterm fetus?
Less likely to have cerebral palsy
Will give at less than 30 weeks gestation, close to 4 hours before birth or within 24 hours of expected birth
Give to mother
Preeclampsia delivery favoring vaginal?
Multiparous mother Cerebral BP Ripe cervix Mature fetus Cephalic presentation
Preeclampsia delivery route favoring c section
Miparous mother Unstable BP Cerebral irritability Un ripe cervix Immature fetus Breech IUGR Abnormal Doppler
Most common reason for grand-mal seizure in preg?
Epilepsy
How to distinguish epilepsy from Preeclampsia?
Bracelet of epileptic woman
Look in handbag for Meds
Gum hypertrophy
Version of Preeclampsia affecting liver/haematologic all
HELLP syndrome
Haemolysis elevated Liver Enzymes Low Platelet Count
DDx HTN in preg?
Chronic HTN
Endocrine: phaeo
Cushing
Renal htn
Only treatment to prevent Preeclampsia?
Low dose Aspirin
CLASP Trial
Theory of Preeclampsia?
Poor placenta growth into the decidua, the arterioles still have smooth muscle, can contract raising BP
