Hypertensive Disorders

Question 1

Why is HTN in the 1st 20 weeks of pregnancy considered chronic HTN?

Question 2

Define chronic HTN(6)

Answer 2

HTN
Before pregnancy
1st half of pregnancy (20wks)
Not attributable to GTD
Persists after 6 weeks after delivery
Taking anti HTN

Question 3

Classify HTN disorders in pregnancy (5)

Question 4

Why is GTD added to chronic HTN definition?

Question 5

Can chronic HTN be masked in pregnancy?

Question 6

Define PIH(7)

Answer 6

HTN,2,2,4,6,6

Question 7

Define HTN(4)

Answer 7

◦Single measurement of DBP ≥ 110mmHg.

◦Two consecutive measurements of SBP≥140mmHg/ DBP  90mmHg taken  4
hours apart

◦MAP ≥ 105mmHg.

◦↑MAP ≥ 20mmHg.

Question 8

What’s the formula for MAP

Answer 8

MAP = DP + 1/3(SP – DP) or

MAP = DP + 1/3(PP)

Question 9

Mild preeclampsia

Answer 9

Mild Preeclampsia:

•SBP 140- 159mmHg

•DBP 90-109mmHg

•1+ proteinuria

Question 10

Severe preeclampsia

Answer 10

•SBP 160mmHg or higher on 2 occasions ≥ 4Hrs apart.

•DBP 110mmHg on 2 occasions ≥ 4Hrs apart

or 120mmHg on 1st occasion

•±Proteinuria of ≥ 2+,

Generalized oedema
•Oliguria  400mls in 24 hours
•Cerebral or visual disturbances
•Epigastric pain
•Pulmonary edema or cyanosis
•Vomiting

Question 11

Principles of management of eclampsia

Answer 11

Mnemonic: ARD
A- admit
R- resuscitate and stabilize
D- deliver

Under resuscitation and stabilization: follow
1. ABC of resuscitation(airway, breathing, circulation and catheter)
2. Control (seizures and BP)
To control seizures: use MgSO4 (any regimen)
To control BP (hydralazine or labetalol)