Hypertensive Disorders in Pregnancy Flashcards
What is PIH?
new-onset hypertension, developing after 20 weeks gestation.
What does PIH stand for?
Pregnancy-Induced HTN
When does PIH develop?
After 20 weeks gestation
What causes PIH?
Systemic reaction to abnormally invasive placenta
Presentation of PIH?
asymptomatic, headaches, blurred vision
Initial investigation for Hypertensive disease in pregnancy?
BP + Urinanalysis + sFLT: PIGF ratio
What BP reading would indicate hypertensive disease in pregancy?
140/90mmHg, +30/+15 in pre-existing hypertension
What Urinanalysis results would indicate hypertensive disease in preganancy?
protein 2+ on dipstick, >30mg/mmol protein-creatinine ratio
What sFLT : PIGF ratio results would indicate hypertensive disease in pregnancy?
> 85 is diagnositic
Name further investigations for hypertensive disease in pregancy?
Bloods, USS, Umbilical artery doppler velocimetry, cardiotocography, auscultation of foetal heart
Which Bloods are requested as part of further investigation of hypertensive disease in pregnancy?
FBC, U+E, LFT
How often are blood requested as part of further investigation of hypertensive disease in pregnancy?
Twice weekly
What is the Ultrasound scan used for as part of further investigation of hypertensive disease in pregnancy?
To assess foetal growth and AFI
How often is an USS completed as part of further investigation of hypertensive disease in pregnancy?
2 weekly
What is the umbilical artery doppler velocimetry used for as part of further investigation of hypertensive disease in pregnancy?
assess placental perfusion
How often is the umbilical artery doppler velocimetry done as part of further investigation of hypertensive disease in pregnancy?
2 weekly
What is cardiotocography used for as part of further investigation of hypertensive disease in pregnancy?
upon diagnosis, + if RFM, PV bleed, abdo pain, deterioration
How often is auscultation of foetal heart completed as part of further investigation of hypertensive disease in pregnancy?
offered at every appointment
What is given for prevention of Hypertensive disease in pregnancy?
75mg aspirin OD from 12/40 onwards
First Line treatment for Hypertensive disease in pregnancy
labetalol (beta blocker)
Second Line treatment for Hypertensive disease in pregnancy
nifedipine
Third Line treatment for Hypertensive disease in pregnancy
methyldopa
for Hypertensive disease in pregnancy Consider early delivery at…..
37 weeks
Name some complications of Hypertensive disease in pregnancy
Eclampsia, HELLP syndrome, Placental Abruption, Disseminated intravascular coagulation