Hypertensive Disorders Of Pregnancy

Question 1

Diastolic range of mild hypertension

Answer 1

90-100

Question 2

Diastolic range of moderate hypertension

Answer 2

100-110

Question 3

Diastolic range of severe hypertension

Answer 3

110+

Question 4

Maternal factors that carry the risk of developing pre-eclampsia

Answer 4

Previous pre eclampsia, pre existing medical disorders, autoimmune diseases and a raised BP at first visit

Question 5

Screening tests of Pre-eclampsia

Answer 5

Uterine artery Doppler studies, PIGF (placental growth factor) and Plasma PAPP-A

Question 6

According to the Fetal med foundation, risk for pre-eclampsia can be derived from a combination of bio markers, this is by calculating the PI (mean uterine pulsatility index) what is the formula

Answer 6

PSV-EDV/TAV
Peak systolic velocity -End diastolic velocity / by Timed average velocity

Question 7

Pregnant women at risk of pre-eclampsia are advised to take what and when

Answer 7

Prophylactic Low dose aspirin (75-150mg) daily. From 12 weeks until birth.

Question 8

while the majority of women are asymptomatic, what’s the symptoms

Answer 8

Severe headache, blurred vision, severe pain just below the ribs, vomiting, and a sudden swelling of the limbs

Question 9

Pre eclampsia diagnostic BP

Answer 9

> 140/90mmHg

Question 10

HELLP syndrome is a fever form of pre-eclampsia, what does the acronym stand for

Answer 10

Hemolysis, elevated liver enzymes, and low platelet count

Question 11

Management of HELLP:

Answer 11

Stabilizing mother, transfusion of blood components, and pregnancy termination. In that order

Question 12

A woman with BP >=160/110mmHg requires urgent treatment why

Answer 12

Significant risk of intracranial hemorrhage

Question 13

What is the aim of maternal treatment in pre-eclampsia

Answer 13

Stabilize BP and prevent convulsions

Question 14

Is there a cure for pre-eclampsia?

Answer 14

No. Just to terminate the pregnancy

Question 15

Diagnostic investigations of pre-eclampsia

Answer 15

CBC, Renal and liver function tests. Ultrasound for fetal growth. And Umbilical artery doppler

Question 16

Antihypertensive medication of choice

Answer 16

Labetalol.

Question 17

If Labetalol is not suitable?

Answer 17

Oral nifedipine

Question 18

If Labetalol and Oral Nifedipine aren’t suitable?

Answer 18

Methyl Dopa

Question 19

What antihypertensive medication do we give in Severe PET

Answer 19

IV hydralazine

Question 20

When treating Hypertension, we avoid giving two medications, what are they

Answer 20

Diuretics and ACE inhibitors

Question 21

We consider giving what to women with Severe PET if they are deteriorating in their labs or planning to give birth in 24 hours

Answer 21

IV magnesium sulphate

Question 22

What exactly are our indictions for delivery in pre-eclampsia?

Answer 22

> 37 weeks gestation, uncontrolled BP despite trying 3 or more antihypertensives. And or progressive deterioration in their labs

Question 23

If a woman has taken Methyl Dopa, why do we stop it 2 days after birth?

Answer 23

Its side effects include sedation and depression.

Question 24

What is Eclampsia

Answer 24

The onset of seizures in a woman with pre eclampsia

Question 25

Eclampsia’ is preceded by a disorientation stage, explain it

Answer 25

The woman becomes restless and develops spasmodic respiration.

Question 26

Within a minute after the disorientation stage, what happens to the woman

Answer 26

She convulses, her breathing ceases, her nootg becomes frothy and she becomes comatosed.

Question 27

Ok so the woman is experiencing eclampsia, first step?

Answer 27

ABC. Airway, breathing, circulation. Left lateral position and keep mouth clear of saliva Admin high flow oxygen And IV access for blood and labs

Question 28

Medical management of eclampsia

Answer 28

Anticonvulsant: Mangnesium sulphate Antihypertensives: Labetalol, nifedipine, IV hydralazine, so on.

Question 29

Your eclampsia patient whom you have Magnesium sulphate to, shows signs of magnesium toxicity, what does we do?

Answer 29

Immediately 1gm of Calcium Gluconate IV (antidote to magnesium toxicity)

Question 30

After our ABC’s in eclampsia, what next?

Answer 30

Terminate the pregnancy.