Hypertensive Disorders in Pregnancy

Question 1

What is pre-eclampsia?

Answer 1

New onset hypertension in pregnancy with end organ dysfunction resulting in proteinuria.

Typically occurs after 20 weeks due to spiral arteries forming abnormally, creating high vascular resistance.

The word eclampsia refers to seizures and can occur if pre-eclampsia is untreated

Question 2

How does pre-eclampsia present?

Answer 2

Symptoms associated with hypertension:

• Headache
• Visual disturbance
• Nausea/vomiting
• Oedema
• Reduced urine output

Question 3

How is pre-eclampsia diagnosed?

Answer 3

Systolic BP above: 140
Diastolic BP above: 90

PLUS any of:

• Proteinuria (+1 or more on urine dip)
• Evidence of organ dysfunction (raised creatinine, elevated LFTs, seizures, thrombocytopaenia)
• Evidence of placental dysfunction (foetal growth restriction)

Question 4

What are the complications of pre-eclampsia?

Answer 4

• Maternal organ damage
• Foetal growth restriction
• Seizures
• Early labour
• HELLP
• Death

Question 5

What is HELLP Syndrome?

Answer 5

A triad of:

1. Haemolysis
2. Elevated LFTs
3. Low platelets

It is a complication of eclampsia/pre-eclampsia