Hypertension in pregnancy Flashcards
3 main symptoms of pre eclampsia
Hypertension
Proteinuria (UPCR >30mg/mmol)
Oedema
timing of Early pre-eclampsia vs late pre-eclampsia
<34 weeks - early
>34 weeks - late
which has a higher risk of complications - early or late pre-eclampsia?
early
pre-eclampsia symptoms
non-specific!:
- Headache
- Visual disturbance
- Epigastric / RUQ pain
- Nausea / vomiting
- Rapidly progressive oedema
pre-eclampsia signs
- Hypertension
- Proteinuria
- Oedema
- Abdominal tenderness
- Disorientation
- Small for Gestational Age (SGA) Fetus
- Intra uterine fetal death
- Hyper-reflexia / involuntary movements / clonus
investigations for pre-eclampsia
- Urea & Electrolytes
- Serum Urate
- Liver Function Tests
- Full Blood Count
- Coagulation Screen
- Urine Protein Creatinine Ratio (UPCR)
- Cardiotocography
- Ultrasound - fetal assessment
high risk for pre-eclampsia
hypertensive disease in previous pregnancy
CKD
autoimmune disease e.g. lupus, antiphospholipid syndrome
type 1 or type 2 diabetes
chronic hypertension
moderate risk for pre-eclampsia
- nulliparity
- age 40 or over
- pregnancy interval of >10yrs
- BMI of 35 or more
- FHx of pre-eclampsia
which women should take aspirin in pregnancy from 12 weeks-birth
1 high risk factor or more than one moderate
when is aspirin started for pre-eclampsia risk? what dose?
12 weeks
150mg
does control of BP reduce risk of developing pre-eclampsia?
nope
drugs used for treatment of hypertension in pregnancy
labetalol
methyldopa
nifedipine
foetal surveillance in pre-eclampsia
Foetal Movements - asked at every appointment
CTG - daily if inpatient
Ultrasound:
-Biometry
-Amniotic Fluid Index
-Umbilical Artery Doppler
pregnant woman with systemic BP >160mmHg, what should we do
admit to hospital
cure for pre-eclampsia
birth
