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DM2 Prep- Obstetrics > Hypertensive Disease In Pregnancy > Flashcards

Hypertensive Disease In Pregnancy Flashcards

1
Q

Overall Rate of preeclampsia

A

3-5%

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2
Q

Incidence of eclampsia

A

27.5 per 10000 maternities

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3
Q

Eclampsia rate in patients with preeclampsia

A

1%

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4
Q

Chronic hypertension with superimposed preeclampsia

A

25%

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5
Q

Risk of preeclampsia if mother had preeclampsia

A

20-25%

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6
Q

Risk of preeclampsia if sister has preeclampsia

A

35-40%

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7
Q

Risk of recurrent pregnancy induced hypertension

A

11-15%

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8
Q

PIH in current pregnancy..
Risk of preeclampsia in future ?

A

7%

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9
Q

Preeclampsia in current pregnancy…
Risk of PIH in future

A

13-53%

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10
Q

Risk of recurrent preeclampsia if delivery <34 weeks due to severe pe, hellp syndrome or eclampsia

A

25%

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11
Q

Risk if recurrent preeclampsia if delivery 34-37 weeks

A

23%

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12
Q

PIH developing CHTN

A

3%

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13
Q

Preeclampsia risk of :
Cardiovascular event

A

1.5-3 fold

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14
Q

Pre eclampsia risk of
Cardiovascular death

A

2 fold

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15
Q

Pre eclampsia risk of
Stroke

A

2-3 fold

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16
Q

Pre eclampsia risk of
Developing HTN

A

2-5 fold

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17
Q

PIH risk
Cardiovascular event

A

1.5-3 fold

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18
Q

PIH risk
Developing HTN

A

2-4 fold

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19
Q

High risk factors for developing pre eclampsia (5)

A
  • CKD
  • Preexisting Diabetes
  • Chronic HTN
  • Previous preeclampsia
  • Autoimmune disease
20
Q

Moderate risk factors of developing pre eclampsia (6)

A
  • BMI >35kg/m2 (Fat)
  • primigravida (First)
  • Family history of preeclampsia (Family)
  • interpregnancy interval >10 years (Far)
  • 40 years old and above (Forty)
  • multiple pregnancy (Fetus)
21
Q

Indications for delivery (5)

A
  • inability to control BP on 3 maxed out agents
  • worsening biochemical markers: platelet <100, creatinine >90 umol/l, albumin <20g/l
  • eclampsia, pulmonary edema, stroke
  • symptoms of impending eclampsia
  • fetal compromise: fetal distress, severe for, reversed umbilical artery diastolic flow
22
Q

MOA : nifedipine

A

Calcium channel blocker

23
Q

MOA: Labetolol

A

Alpha and beta adrenergic blocker

24
Q

MOA: hydralazine

A

Direct smooth muscle relaxant resulting in vasodilation

25
Q

MOA methyldopa

A

Alpha adrenergic agonist
- reduced total peripheral resistance
- decreased systemic blood pressure

26
Q

MgSO4 therapeutic Range

A

2-4 mmol/l

27
Q

MgSO4 toxicity level

A

3.5-5 mmol/l

28
Q

Incidence HELLP Syndrome

A

0.5-0.9%

29
Q

Risk of placental abruption with preexisting HTN

A

4%

30
Q

HELLP syndrome recurrence
Developed <32 weeks

A

60%

31
Q

HELLP Syndrome recurrence
Developed @>32 weeks

A

10%

32
Q

Percentage of patients who present with eclampsia that have severe htn

A

40%

33
Q

Recurrence rate of eclampsia

A

10%

34
Q

Maternal mortality associated with eclampsia

A

0.4- 5.8%

35
Q

Mortality rate of eclampsia

A

1:50

36
Q

Findings if the ASPRE study

A
  • reduction in delivery with pre eclampsia before 37 weeks with the use of asa 150mg from 4.3% to 1.6%
37
Q

Percentage of patients with pre eclampsia who develop HELLP syndrome

A

5-20%

38
Q

What percentage of patients develop HELLP postpartum

A

25%

39
Q

Is HELLP always preceeded by hypertension and proteinuria?

A

No

1/3 patient would have neither

40
Q

Mortality rate of HELLP

A

1% in resource rich countries

41
Q

Perinatal mortality with HELLP

A

7-60%

42
Q

Overall risk of hypertensive disorders in pregnancy

A

8-10%

43
Q

Risk preeclampsia in subsequent pregnancy if eclampsia lead to birth <28weeks

A

55%

44
Q

What are renal function test indicate AKI in pregnancy

A

-Serum Urea >17mmol/l requires renal replacement therapy

  • creatinine >90umol/l
45
Q

What percentage of patients with HELLP syndrome have AKI

A

3-15%

46
Q

What percentage of patients with pre eclampsia develop AKI

A

Up to 2 %

47
Q

What percentage of women with untreated APS develop GHTN/preeclampsia

A

30-50%

Decreases to 10% with treatment

DM2 Prep- Obstetrics (23 decks)

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