Hypertension in Pregnancy Flashcards

1
Q

What happens to vessels during pregnancy?

A

Vasodilation

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2
Q

Is blood pressure high or low in early pregnancy?

A

Low

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3
Q

Is blood pressure high or low in late pregnancy?

A

High

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4
Q

When is the lowest blood pressure in pregnancy?

A

22-24 weeks

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5
Q

What are the parameters/criteria for diagnosing hypertension in pregnancy?

A

Greater than 140/90 on 2 occasions

Diastolic greater than 110

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6
Q

If hypertension persists within 3 months of delivery of a baby, what is the likely diagnosis?

A

Pre-existing (undiagnosed) hypertension

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7
Q

When should pregnancy-induced hypertension resolve by?

A

6 weeks following delivery

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8
Q

What are the 3 main features of pre-eclampsia?

A

Hypertension
Proteinuria
Oedema

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9
Q

How much proteinuria meets the criteria for pre-eclampsia?

A

0.3 g/l or more
0.3 g or more in 24 hour period
2+ on dipstick

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10
Q

Describe the pathogenesis of pre-eclampsia

A

Abnormal placentation and failure of trophoblast invasion cause spiral arteries to stay as high resistance/low flow vessels, leading to placental endothelial damage and thrombosis

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11
Q

What syndrome related to liver disease are women with pre-eclampsia at risk of?

A

HELLP syndrome

Haemolysis, Elevated Liver enzymes, Low Platelets

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12
Q

List clinical features of pre-eclampsia

A

Headache
Visual disturbance
Epigastric/RUQ pain
Nausea/vomiting

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13
Q

How can pre-eclampsia be screened for/predicted?

A

Uterine artery doppler to assess blood flow - if poor flow (notching) then high risk

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14
Q

What are the 4 main drugs used for hypertension in pregnancy?

A

Methyldopa
Labetolol
Nifedipine
Hydralazine

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15
Q

When is methyldopa contraindicated in hypertension in pregnancy?

A

Depression

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16
Q

What is the only cure for pre-eclampsia?

A

Delivery of baby

17
Q

What is eclampsia?

A

Grand mal seizure occurring with pre-eclampsia features

18
Q

Is eclampsia more common antepartum, intrapartum or postpartum?

A

Postpartum

19
Q

What should be given to treat eclampsia?

A

Magnesium sulphate