Hypertensive Disorders in Pregnancy

Question 1

Leading cause of maternal death
5-10% of pregnancies

Answer 1

Hypertensive disorders

Question 2

Classifications

Answer 2

Chronic
Gestational
Superimposed
Pre-eclampsia/ eclampsia

Question 3

Chronic

Answer 3

8% of pregnancies
>140/90 before 20 weeks or after 12 weeks

Question 4

Gestational

Answer 4

> 140/90 after 20 weeks of gestation
absence of proteinuria

Question 5

Superimposed

Answer 5

Chronic and worsening developing new-onset proteinuria after 20 weeks

Question 6

Pre-eclampsia

Answer 6

2-8% incidence
>140/90 mmHg after 20 weeks of gestation
proteinuria

Question 7

Risk factors

Answer 7

Family history
Nulliparity
Genetic predisposition
Multifetal pregnancy
>35 years of age
IVF
Pre existing Hypertention
Diabetes
Chronic kidney disease
Obesity
Hmol
Trisomy 13

Question 8

Negative risk factors

Answer 8

Maternal smoking
Prolonged sexual cohabitation

Question 9

What does shallow placentation cause?

Answer 9

Reduced placental perfusion
Intrauterine growth restriction
Reduced fetal oxygen and nutrient intake

Question 10

Which clinical manifestations could indicate preeclampsia?

Answer 10

Elevated AST levels
Seeing circles around lights
Urinating very little

Question 11

Which manifestations reflect increased capillary permeability in preeclampsia?

Answer 11

Generalized edema
Fluid in the lungs
Protein in the urine

Question 12

Which vascular manifestations occur in preeclampsia?

Answer 12

Cerebral edema
Damaged capillaries and leakage
Coagulation abnormalities

Question 13

Diagnosis Pre eclampsia

Answer 13

> 140/90 mm Hg on two separate occasions at
least 4 hours apart
Proteinuria, Protein > 300 mg (PCR) > 0.3 g

Question 14

Diagnosis Severe Preeclampsia

Answer 14

> 160/110 mm Hg
Platelet < 100,000/mm3
Serum creatinine increase > 1.1 mg/dL
Pulmonary edema

Question 15

treatment for preeclampsia

Answer 15

Delivery of the placenta

Question 16

Management

Answer 16

Prenatal care
BP monitoring
Managing complications
Timely delivery
corticosteroids
Pp monitoring

Question 17

Surveillance

Answer 17

Non stress test
Ultrasound
McDonalds measurement

Question 18

How long should the maternal blood pressure be monitored postpartum?

Answer 18

72 hours

Question 19

Eclampsia

Answer 19

Preeclampsia and grand mal seizure activity

Question 20

Symptoms

Answer 20

Frontal headaches
Blurred vision
Photophobia
Epigastric pain
Altered mental status
NONE

Question 21

Variants

Answer 21

Hemolysis
Elevated
Liver enzymes
Low
Platelet count

Question 22

Medications to manage pre eclampsia

Answer 22

Calcium channel blockers
Beta-blockers
Nonsteroidal anti-inflammatory drugs
Antiadrenergic agents
Diuretic

Question 23

Magnesium sulfate,

Answer 23

prevent seizures

Question 24

MS antidote

Answer 24

Calcium gluconate

Question 25

Hydralazine

Answer 25

Direct peripheral vasodilation Increase cardiac output and heart rate 5-10mg

Question 26

Labetalol

Answer 26

Beta blocker given for clients with severe preeclampsia

Question 27

Nifedipine

Answer 27

IV 30-120mg/dl Given for individuals w severe preeclampsia

Question 28

Methyldopa

Answer 28

Antihypertensive Given to expectant, antepartum

Question 29

Gestational Hypertention

Answer 29

>140/90 after 20 weeks

Question 30

Preeclampsia

Answer 30

Gestational hypertension w proteinuria

Question 31

Severe Preeclampsia

Answer 31

>160/110 Pulmonary edema HELLP syndrome Renal insufficiency

Question 32

Eclampsia

Answer 32

HBP Proteinuria Seizures