Hypertension in pregnancy

Question 1

How do you use nifedipine in severe range BPs?

Answer 1

Recheck in 15 minutes, if elevated nifedipine 10, check in 20, if still elevated, do nifedipine 20 (can do this twice), if this fails, can turn to IV labetalol 20

Question 2

How often do you need to check once severe range BPs come down?

Answer 2

10 minutes for 1 hour, 15 minutes for second hour, q30 min for third hour, and every hour for 4 hours

Question 3

how do you use IV labetalol in severe range BPs?

Answer 3

IV labetalol 20 mg > 40 mg > 80mg every 10 minutes until improves

Question 4

What counts as pre w/ SF? SF criteria - 6 of them.

Answer 4

1) > 160/> 110
2) plt < 100K
3) Cr > 1.1, or twice baseline
4) Elevated LFTs twice normal
5) Pulmonary edema
6) Headache not responding to meds OR vision changes

Question 5

When can you diagnosis gestational HTN or preE in pregnancy>

Answer 5

after 20 weeks, with bps separated by 4 hours > 140/>90

Question 6

What is the criteria for HELLP?

Answer 6

hemolysis (LDH > 600)
elevated LFTs > 2x normal
low platelets < 100K

Question 7

How is gestational HTN defined?

Answer 7

> 140 OR/ > 90 two times, 4 hours apart, after 20 weeks of pregnancy

Question 8

How to monitor Magnesium?

Answer 8

Labs atleast q12hrs; monitor every 4-6 hours if renal impairment

Question 9

What is defined as severe hypertension in pregnancy?

Answer 9

Severe hypertension is defined as systolic blood pressure ≥ 160 mm Hg or diastolic blood pressure ≥ 110 mm Hg, measured twice, at least 15 minutes apart.

Question 10

How is preE defined?

Answer 10

hypertension with new onset proteinuria (> 300 mg/24 hours) after 20 weeks gestation, or, if no proteinuria, diagnosis requires ≥ 1 of severe features