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OBGY Week 4 > Hypertension in pregnancy > Flashcards

Hypertension in pregnancy Flashcards

1
Q

Blood pressure physiological changes in pregnancy?

A

Pregnacny–> Vasodilation so falls in early preg

Then increases steadily until term

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2
Q

Definitions of hypertension?

A

> 140/90 on 2 occasions

DBP>110

> 30/15 compared to booking BP

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3
Q

Types of hypertension in pregnancy?

A

Pre existing

Pregnancy induced

Pre eclampsia

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4
Q

What is pre eclampsia?

A

Hypertension + proteinuria

Oedema but absence does not exclude diagnosis

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5
Q

Pathogenesis of pre eclampsia?

A

Failure of normal vascular remodelling

Spiral arteries failt to become high capacitance, low resistance vessels

Placental ischameia–> endothelial damage

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6
Q

CNS disease resulting from pre eclampsia?

A 
Eclampsia
Hypertensive encephalopathy
Intracran. haemorrhage
Cerebral oedema
Cortical blindness
Cranial nerve palsy
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7
Q

Renal disease resulting from pre eclampsia?

A 
decrease GFR
Proteinuria
Increase uric acid
Increased creatinine
Oliguria
AKI
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8
Q

Liver disease resulting from pre eclampsia?

A

HELLP syndrome

Haemolysis, elevated liver enzymes
Low platelets

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9
Q

Haematological disease resulting from pre eclampsia?

A 
Decreased PV
Haemoconcentration
Thrombocytopenia
Haemolysis
Disseminated intravascular coagulation
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10
Q

Cardiac/pulmonary disease resulting from pre eclampsia?

A

Pulmonary oedema–>ARDS

Embolus

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11
Q

Placental disease resulting from pre eclampsia?

A

IUGR

Placental abruption

Intrauterine death

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12
Q

Symptoms of pre eclampsia?

A 
Headache
Vision disturbance
Epigastric/RUQ pain
N + V
Rapidly progressive oedema
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13
Q

Signs of pre eclampsia?

A

HTN
Proteinuria
Oedema
Abdo tenderness etc etc

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14
Q

Ix for pre eclampsia?

A 
U=E
Urate
LFT
FBC
Coag
UPCR
CTG
US
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15
Q

Medical risk factors of pre eclampsia?

A 
Pre existing renal disease
Pre existing HTN
DM
CTD
Thrombophilia
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16
Q

Treatment for Hypertension in pregnancy?

A

Labetalol- A and B blocker

Methyl dopa- A blocker

Nifedipine- Ca blocker

Hydralazine- Vasodilator

17
Q

Indications for delivery?

A 
Term
Inability to control BP
Rapidly deteriorating biochem
Eclampsia
Fetal compromise
18
Q

What is eclampsia?

A

Tonic clonic seizure with features of pre eclampsia

19
Q

Management of eclampsia?

A

Control BP

Stop/prevent seizure

Fluid balance

Delivery

20
Q

Antihypertensives in eclampsia?

A

IV Labetalol

IV hydralazine

21
Q

Seizure treatment in eclampsia?

A

Magnesium sulphate IV

If persistent Diazepam IV

22
Q

What role does aspirin play in post partum management?

A

Inhibits COX–> Prevents TXA 2 synthesis

Reduces PET

OBGY Week 4 (8 decks)

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