Hypertensive Disorders in Pregnancy Flashcards
how does BP change in pregnancy
falls to the lowest in 2nd trimester then rises again to normal by the 3rd trimester
what is the difference between gestational hypertension and pre-eclampsia
the present of proteinuria
what is the definition of pre-eclampsia
BP >140/90 and proteinuria of >0.3g/24h after 20 weeks
what is eclampsia
epileptic fits during pregnancy
how is pre-eclampsia cured?
giving birth
what is considered early onset pre-eclampsia
<34 weeks
what causes pre-eclampsia
early onset caused by insufficient invasion of placental arteries causing blood flow resistance and oxidative stress leading to oversecretion of proteins that cause more endothelial damage, vasoconstriction, clotting dysfunction and increased permeability.
what BP is considered severe pre-eclampsia
> 160/110
how many % of nulliparous women have pre-eclampsia
6%
what are risks for pre-eclampsia
previous pregnancy w/ hypertensive disease CKD autoimmune disease T1 T2 DM chronic hypertension
nulliparous >40 age >35 BMI >10 years since last pregnancy family hx multiple babies
clinical features of pre-eclampsia
headache abdominal pain drowsiness visual disturbance N and V
signs of pre-eclampsia
HELLP
haemolysis: dark urine and anemia
EL: elevated liver enzymes cx epigastric pain, liver failure and clotting dysfunction
LP: low platelets
edema more than usual pregnancy
how to treat eclampsia?
magnesium sulphate and ICU
possible maternal complications of pre-eclampsia
cerebrovascular haemorrhage eclampsia liver damage kidney failur pulmonary edema
possible fetal complications with pre-eclampsia
still birth IUGR preterm birth placental abruption hypoxia
