Hypertension in Pregnancy Flashcards
Triad of pre-eclampsia
New onset hypertension (after 20w gestation)
Proteinurea
Additional organ involvement
Clinical Features of pre-eclampsia
Hypertension
Proteinurea
Headache/Visual disturbance
Papilloedema
RUQ/Epigastric pain
Hyperreflexia
PLT <100
Abnormal liver enzymes/HELLP
High risk factors for pre-eclampsia (5)
Previous hypertension in pregnancy
CKD
Autoimmune disorders
DM
HTN
Moderate risk factors for pre-eclampsia (6)
1st pregnancy
>40YO
Pregnancy interval >10 years
BMI >35
FH pre-exlampsia
Multiple pregnancy
When to treat pregnant women with aspirin?
> 1 high RF or >2 mod RF
How to prevent pre-eclampsia?
Aspirin 75mg-100mg from 12 weeks gestation until birth
How to treat pre-eclampsia?
Oral labetalol
- nifedipine/hydralazine if asthmatic
Delivery of baby is definitive management
Complications of pre-eclampsia
Eclampsia (seizures)
Fetal complications (IUGR, prematurity)
Hemorrhage: placental abruption, intra-abdominal, intra-cerebral
HF
How to treat eclampsia?
Magnesium sulfate
- continue treatment for 24 hours after last seizure or delivery
What to monitor during eclampsia?
UO
Reflexes
RR
02
Definition of hypertension in pregnancy?
BP >140/90 OR
Increase from booking readings of >30 systolic or >15 diastolic
What classes as pre-existing hypertension?
A history of hypertension ebfore pregnancy or an elevated BP >140/90 before 20 weeks gestation
What classes as gestational hypertension?
Hypetension occuring in second half of pregnancy (after 20w)
How to treat a patient with hypertension in or prior to pregnancy?
Stop hypertensive meds and start alternative e.g. labetalol or nifedipine (if asthmatic)
Complications of gestational diabtes?
Increased risk of future pre-eclampsia or HTN
