HYPERTENSION IN PREGANANCY

Question 1

Delta htn

Answer 1

MAP rises suddenly
But , BP is within normal range

Question 2

ACOG CLASSIFICATION

Answer 2

I. Pre eclampsia - eclampsia syndrome
II. Gestational htn
III. Chronic htn in pregnancy
IV. Chronic htn with superimposed pre eclampsia

Question 3

Definition of HTN in pregnancy

Answer 3

BP >=140/90 mm hg on 2 occasions atleast 4 hrs apart

OR
either systolic >140 mmHg
Or DIASTOLIC >90 mm hg

OR
BP >=160/110 mm hg on 2 occasions within 15 minutes apart
( To facilitate early administration of Anti htn )

Question 4

Gold std equipment of BP measurements

Answer 4

SPHYGMOMANOMETER
SBP: kortokoff sound 1 ( apperance of sound )
DBP: Korotkoff sound 2 ( disappearance of sound )

Question 5

BP cuff for upper arm

Answer 5

Should cover atleast 40% of surface area
Arm cuff : if MUAC - 35-44 CM
THIGH CUFF : if MUAC - 45-52 CM

Question 6

Maximum physiological decrease in BP in which trimester ?

Answer 6

2 nd

Question 7

Features of proteinuria in PIH

Answer 7

Non selective proteinuria
Not associated with Red casts , nephritis , nephrotic syndrome

Only GRANULAR casts seen - Fine or coarse

Question 8

Proteinuria assessment in PIH

Answer 8

Screening : Dipstick >= + 1

Diagnosis :
Urine protein : Creatinine ratio >= 0.3
24 hr urine protein >= 300 mg /day

Question 9

Diagnosis of proteinuria + nephrotic syndrome + red cell casts

Answer 9

Chronic htn with underlying renal disease

Question 10

Signs of end organ damage in PIH 🌟 PLease Cee my Head and Eyes

Answer 10

Platelet count <1 lakh
Pulmonary edema
Liver enzymes elevated upto 2 times
S. Creatinine >=1.1 mg /dl or doubling of baseline
Headache
Visual symptoms

Question 11

Pre eclampsia classification based on onset

Answer 11

Early : 20-34 weeks
Preterm / late onset : 34-37 weeks
Late onset : >37 weeks

Question 12

DEFN of ECLAMPSIA

Answer 12

occurence of a new onset generalised tonic clinic seizure or coma in a patient with pre eclampsia

Question 13

Types of ECLAMPSIA

Answer 13

Antepartum ( most common , best prognosis )
Intrapartum
Post partum ( 48 hrs post delivery )

Question 14

Supportive findings of pre eclampsia which are Non diagnostic

Answer 14

Oliguria
Iugr
Proteinuria

Question 15

Signs of impending eclampsia

Answer 15

BP: >= 160 / 110 mmHg
Headache
Visual symptoms
Epigastric pain
Seizure - GTCS
Signs of end organ damage present