Hypertensive Disorders of Pregnancy Flashcards
What is the blood pressure threshold for diagnosing hypertensive disorders of pregnancy?
BP > 140/90
What defines Pregnancy-Induced Hypertension (PIH)?
HTN without proteinuria >20/40 GA
Deliver at 39/40
What are the two classifications of pre-eclampsia?
Mild and severe PET
What is the blood pressure criteria for severe pre-eclampsia?
> 160/110
How long does blood pressure typically resolve after delivery in cases of pre-eclampsia?
6 weeks
What is the pathophysiological cause of high blood pressure in pre-eclampsia?
Vasospasm and generalized endothelial damage
What is the significance of the failed transformation of uterine spiral arteries in pre-eclampsia?
Prevents high-flow, low-impedance utero-placental circulation
What is the proteinuria diagnostic criteria for significant proteinuria?
Protein:creatinine ratio >30 mg/mol
What is the initial antibiotic prophylaxis recommended for pre-eclampsia?
IV benzylpenicillin 3g stat dose followed by 1.5g IV q4h until delivery
What are the cardiovascular effects of pre-eclampsia?
Vasoconstriction, increased intravascular pressure, and edema
What is HELLP syndrome associated with in pre-eclampsia?
Increased liver enzymes due to subendothelial fibrin deposition
What are common signs and symptoms of eclampsia?
Headache, blurred vision, seizures, stroke, puffy face, dyspnea, RUQ pain
What are the demographic risk factors for pre-eclampsia?
1st pregnancy, age >40, BMI >30, African American, multiple pregnancies, new partner
What should be monitored in a patient with pre-eclampsia?
Blood pressure, blood tests (FBC, LFTs), urine protein levels
What is the first-line medication for treating hypertension in pre-eclampsia?
Labetalol 200mg
What is the purpose of administering MgSO4 in pre-eclampsia?
Seizure prophylaxis and fetal neuroprotection
What are the contraindications for using labetalol?
Severe asthma and heart failure
What is the recommended management for chronic hypertension in pregnancy?
Switch to labetalol, nifedipine, or methyldopa if persistently >150/100
What is IUGR and how is it defined?
Failure of a foetus to achieve its genetic growth potential
What are the two types of IUGR?
Symmetrical and asymmetrical
What is a common maternal risk associated with hypertension in pregnancy?
Pre-eclampsia develops in 1/3 of hypertensive women
What is the definition of SFD?
Foetus <10th centile for estimated foetal weight for GA
What are some maternal factors that increase the risk of IUGR?
Extreme of age, short stature, underweight, primiparity
What is the recommended management for a patient with IUGR?
Optimise maternal nutrition, manage risk factors, serial U/S
What should be done for fetal neuroprotection in cases of IUGR?
Administer MgSO4 if <32/40
What are some complications associated with IUGR?
Emergency CS, necrotising enterocolitis, preterm birth, perinatal mortality
