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Hypertension in Pregnancy Flashcards

1
Q

Define gestational hypertension

A

New hypertension >20 weeks term

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2
Q

Define pre-eclampsia

A

Characterised by new hypertension >20 weeks gestation + proteinuria in pregnancy

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3
Q

Hypertension criteria in pre-eclampsia

A

> 140/>90mmHg

>4hrs apart

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4
Q

What is the proteinuria criteria in pre-eclampsia

A

> 300mgms/24hrs

Protein:Creatinine ration >30mgms/mmol

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5
Q

Define moderate hypertension in pregnancy

A

100-109/150-159

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6
Q

Define mild hypertension in pregnancy

A

90-99/140-149

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7
Q

Define severe hypertension in pregnancy

A

> 110/>160

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8
Q

High risk risk factors for pre-eclampsia

A 
Previous severe or early onset pre-eclampsia 
Chronic hypertension 
CKD 
DM 
Autoimmune disease
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9
Q

Moderate risk risk factors for pre-eclampsia

A 
1st pregnancy 
>40yrs
Pregnancy interval >10yr 
BMI>30 
FH pre-eclampsia 
Multiple pregnancy
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10
Q

Signs of pre-eclampsia

A 
Severe hypertension 
Proteinuria 
Epigastric or RUQ abdo. pain/tenderness 
Brisk reflexes 
Clonus 
Papilloedema
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11
Q

Define eclampsia

A

Tonic-clonic seizures + pre-eclampsia

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12
Q

Biochemical signs of pre-eclampsia

A 
Increased liver enzymes 
Increased bilirubin 
Increased urea
Increased creatinine 
Increased urate
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13
Q

Ix for pre-eclampsia

A 
Frequent BP checks 
Urine protein (dipstick)
Protein:creatinine ratio
FBC 
LFTs
Renal function tests 
USS for fetal growth monitoring
CTG
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14
Q

Rx for chronic hypertension in pregnancy

A

Pre-pregnancy care

Change anti-hypertensive drugs

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15
Q

What are safe anti-hypertensive drugs in pregnancy

A

Lebetalol
Nifedipine
Methyldopa

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16
Q

What is the problem with ACEi in pregnancy

A

They are teratogenic

17
Q

What is the definitive cure of pre-eclampsia

A

Delivery of the baby and the placenta

18
Q

If inducing labour what should be given to the foetus and what for

A

Corticosteroids for fetal lung development

19
Q

when do eclamptic females have seizures?

A

38% antenatally
18% intra-partum
44% postnatally

20
Q

Rx for eclampsia

A

ABCDE
Magnesium sulphate bolus + IV infusion (for seizure)
IV Labetelol
Monitor fetes using CTG

21
Q

Rx for seizures in eclampsia

A

Magnesium sulphate bolus + IV infusion

22
Q

Rx for BP control in eclampsia

A

IV Labetolol

23
Q

Clinical features of Eclampsia

A 
Headache 
Hyper-reflexia 
Nausea
Vomiting 
Gastric pain 
Visual disturbances
Generalised oedema
24
Q

What is the prophylaxis for PET in subsequent pregnancies

A

Low dose aspirin from 12 weeks - delivery

25
Q

What is HELLP Syndrome characterised by

A

H (haemolysis)
EL (elevated liver enzymes)
LP (Low platelets)

26
Q

What does HELLP syndrome usually occur in association with

A

Pre-eclampsia

27
Q

Clinical features of HELLP syndrome

A 
epigastric pain 
Hypertension 
Proteinuria 
Oedema 
Hepatomegaly 
Increased liver enzymes 
Decreased platelet count 
Nausea/Vomiting
28
Q

Fetal complications of PET

A 
Impaired placental perfusion 
Small baby 
IUGR 
Fetal distress
Prematurity 
Increased PN mortality

Reproduction (14 decks)

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