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Reproductive > hypertension in pregnancy > Flashcards

hypertension in pregnancy Flashcards

1
Q

hypertension in pregnancy - types

A
  1. Gestational hypertensiocn (pregnancy-induced hypertension)
  2. Preeclampsia
  3. Eclampsia
  4. HELLP syndrome
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2
Q

Gestational hypertension (pregnancy-induced hypertension) - characteristics

A
  1. BP more than 140/90 after 20th week of gestation
  2. No pre-existing hypertension
  3. No proteinuria or end-organ damage
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3
Q

Gestational hypertension (pregnancy-induced hypertension) - drugs (short mechanism of action) and management

A
  1. hydralazine (vasodilator by cGMP increasing)
  2. labetolol (alpha-beta blocker)
  3. α-methyldopa (a-2 blocker)
  4. nifedipine (dihydropiridine Ca2+ channel blocker)
  5. deliver at 37-39 weeks
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4
Q

Preeclampsia - definition

A

New-onset hypertension with erther proteinuria or end-organ dysfunction after 20th of gestatation

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5
Q

Preeclampsia may preceed to

A

eclampsia (+ seizures) and/or HELLP syndrome

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6
Q

Preeclampsia but before 20 weeks?

A

hydatidiform mole

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7
Q

Preeclampsia is caused by

A

abnormal placental spiral arteries –> endothelial dysfunction, vasoconstriction, ischemia

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8
Q

Preeclampsia - high incidence in …

A
  1. pre-existing hypertension
  2. diabetes
  3. chronic renal disease
  4. autoimmune disorder
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9
Q

Preeclampsia - complications

A
  1. placental abruption
  2. coagulopathy
  3. renal failure
  4. uteroplacental insufficiency
  5. eclpampsia
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10
Q

Preeclampsia - treatment

A
  1. anithypertensive
  2. IV magnesium sulfate (to prevent seizures)
  3. definitive is delivery of fetus
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11
Q

uteroplacental vascular insufficiency??

A

(or Placental insufficiency): placenta is unable to deliver adequate supply fetus

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12
Q

Eclampsia?

A

Preeclampsia + maternal seizures

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13
Q

Eclampsia - complications

A

maternal death due to:

  1. stroke
  2. intracranial hemorrhage
  3. ARDS
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14
Q

Eclampsia - treatment

A
  1. IV magnesium sulfate
  2. antihypertensives
  3. immediate delivery
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15
Q

HELLP syndrome

A 
HELLP: 
1. Hemolysis
2. Elevated Liver enzymes
3. Low Platelets 
a manifestations of severe preeclampsia
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16
Q

HELLP syndrome - blood smear

A

schistocytes

17
Q

HELLP syndrome - can lead to

A

heaptic subcapsular hematomas –> rupture –> severe hypotension

18
Q

HELLP syndrome - treatment

A

immediate delivery

Reproductive (20 decks)

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