Maternal Diseases: Hypertension Flashcards
What does hypertension in pregnancy result in? 4
- Essential hypertension
- Pre- eclampsia
- Eclampsia
- HELLP syndrome
When does Essential hypertension occur?
Before 20 weeks gestation or pre-existing
What is the primary cause of Essential Hypertension? 4
- Obesity
- Family
- Hx
- Diet
What are some secondary causes of essential hypertension? 3
- Renal disease
- Endocrine disorders
- Neurological disorders
What is pre-eclampsia thought be caused by?
Prostaglandin abnormalities.
Prostaglandins affect hypertension in pregnancy how? 4
One of a number of hormone like substances that participate in a wide range of body functions such as
1. Contraction and relaxation of smooth muscle
2. Dilation and constriction of vessels
3. Control of blood pressure
4. Modulation of inflammation
Pre-eclampsia is sometimes referred to as what?
PIH (Pregnancy induced hypertension)
What does pre- eclampsia lead to? 4 (in mom)
- High blood pressure
- Proteinuria
- Edema
- Rapid weight gain
What is High blood pressure in terms of pre-eclampsia? 2
- 140/90mmHg
- Or a systolic pressure that is 15 degrees higher than your normal BP
What are some sonographic signs of pre-eclampsia? 7
- Oligiohydraminos
- Placental infarcts
- Placental abruption
- Decreased placental volumes
- Increased placental maturation
- Fetal demise
- Increased S/D ratio
What s/s are associated with eclampsia? 8
- Headaches
- Blurred vision
- Bleeding
- Disseminated intravascular coagulation (DIC)
- Seizures
- Coma
- Fetal death
- Maternal death
What hypertension test do we do for hypertension during the 1st trimester?
PAPP blood test
What is the PAPP blood test performed in conjunction with?
Nuchal Translucency
What does PAPP stand for?
Pregnancy associated plasma protein
If PAPPA is low it is considered what?
A marker for pre-eclampsia
If PAPPA is low a repeat ultrasound is performed when?
23-24 weeks gestation and uterine artery doppler is performed
If PAPPA is low and we do we repeat ultrasound at 23-24 weeks, what do we look for on the doppler image? 2
- Dicrotic notch
- Low diastolic blood flow
What does doppler look like in hypertension? 3
- High resistance in the umbilical artery
- Low resistance MCA
- Ductus Venosus
What is ductus venosus?
Reversal during atrial contraction
Why is there high resistance in the umbilical artery during hypertension? What is the preferred measurement?
- Low or reversed diastolic flow
- PI is preferred measurement
What does HELLP syndrome stand for?
- Hemolysis
- Elevated Liver Enzymes
- Low Platelets
What is a severe variant of Pre-eclampsia?
HELLP
What do we see during HELLP? 3
- Maternal hypertension
- Edema
- Abdominal pain due to hepatic hemorrhage
What is treatment for pre-eclampsia? 4
- Bed rest
- Medication for hypertension
- Increased monitoring of mother and fetus
- Delivery is the only way to reverse the process
