Hypertension in pregnancy Flashcards
What are the main types of hypertension that can be experienced in pregnancy?
- Chornic hypertension
- Pregnancy induced hypertension (Gestational)
- Pre-eclampsia/Eclampsia
What is gestational hypertension defined as?
Hypertension in the second half of pregnancy (BP - 140/90) in the absence of proteinuria or other features of pre-eclampsia
What are those with gestational hypertension at risk of developing?
Pre-eclampsia
How would you assess hypertension in pregnancy?
Distinguish type
- BP
- Urinalysis
What hypertensive medications are used in pregnancy?
- Labetalol
- Hydralazine
- Nifedipine
- Methyldopa
What antihypertensive drugs should be changed if they are already hypertensive pre-pregnancy?
- ACEi/ARBs - causes birth defects and reduced foetal growth
- Diuretics - volume depletion and fetotoxic
What blood pressure would you want to aim for in a pregnant woman with chronic hypertension?
<150/90 (or 140/90 if end organ damage)
What antiplatelet medication should you give someone from conception until birth if they have chronic hypertension?
Low dose Aspirin
What foetal factors would you want to assess during pregnancy in someone with chronic hypertension?
- Foetal growth
- Amniotic fluid volume
- Umbilical artery dopplers
What medications would you use for inducing labour in someone with hypertension?
Oxytocin - no syntometreine
What are those on methyldopa at risk of post-natally?
Post-natal depression
What should be avoided as hypertensive treatment when a mother is breast-feeding?
Diuretics
What increase in BP is diagnostic of pregnancy induced hypertension?
Increase in BP of 30/15 during pregnancy
Classification of mild HTN
140-149/90-99
Monitor
BP weekly, urine, protein
Classification moderate HTN
150-159/100-109
Start meds
BP 2x weekly
