HYPERTENSIVE DISORDERS (based on T) Flashcards
What is the deadly triad in hypertension in pregnancy?
Hypertension-Hemorrhage and Infection → Maternal morbidity and mortality
What is considered normal blood pressure in an adult patient?
90/60 to 120/90 mmHg with 120/90 being abnormal due to high diastolic pressure
How is hypertension diagnosed in pregnancy?
Empirically when systolic and diastolic blood pressures exceed 140 mmHg and 90 mmHg-respectively.
What was previously used as diagnostic criteria for hypertension in pregnancy before 140/90 mmHg?
Increases of 30 mmHg systolic or 15 mmHg diastolic above pregnancy baseline values.
How common are hypertensive disorders in pregnancy?
Hypertensive disorders complicate up to 10% of pregnancies.
What are the hypertensive disorders in pregnancy?
Preeclampsia-Gestational hypertension-Chronic hypertension.
Which hypertensive disorder in pregnancy is most dangerous?
Preeclampsia syndrome (alone or superimposed on chronic hypertension).
What is Delta Hypertension?
Mean arterial pressures that suddenly rise but still lie within the normal range- may signify preeclampsia.
Which syndrome is associated with hemolysis, elevated liver enzymes, and low platelet count?
HELLP syndrome.
How do you confirm hemolysis in a patient?
CBC and Lactate Dehydrogenase levels.
What happens if a patient has hemolysis and low platelet count?
Spontaneous bleeding.
What defines incomplete HELLP syndrome?
Absence of one criterion of HELLP syndrome.
How is preeclampsia classified by onset?
Early onset: <34 weeks. Late onset: ≥34 weeks. Preterm: <37 weeks. Term: ≥37 weeks.
What defines preeclampsia in terms of blood pressure?
BP ≥ 140/90 after 20 weeks in a previously normotensive woman.
What is a primary diagnostic criterion for preeclampsia?
Proteinuria.
What is the difference between gestational hypertension and preeclampsia?
Gestational hypertension has no proteinuria and resolves by 12 weeks postpartum. whereas preeclampsia involves proteinuria and potential organ dysfunction.
What is chronic hypertension in pregnancy?
BP ≥ 140/90 before pregnancy and persists after 12 weeks postpartum.
What is superimposed preeclampsia on chronic hypertension?
More severe and often accompanied by fetal growth restriction. proteinuria beyond 20 weeks.
What defines eclampsia in terms of blood pressure?
BP ≥ 140/90 after 20 weeks. accompanied by seizures.
Why is gestational hypertension considered a diagnosis of exclusion?
It must be confirmed after 12 weeks postpartum—if the BP normalizes- it’s gestational hypertension-otherwise-it’s chronic hypertension.
What are the risk factors for preeclampsia?
Young and nulliparous
SLE-Nulliparity-Age >35-
Prior stillbirth-CKD-ART-
BMI >30-Multifetal pregnancy
Diabetes-Prior preeclampsia
CHTN-Antiphospholipid antibody.
What is the classic presentation of preeclampsia?
Hypertension-Proteinuria and Edema.
What are the risk factors for gestational hypertension?
Women with blood pressure ≥140/90 after mid-pregnancy without proteinuria.
What is the clinical presentation of gestational hypertension?
Hypertension with or without edema.