Medical Complications Flashcards
How many deaths occur d/t HTN?
20% of maternal deaths
Define chronic HTN
HTN before 20th wk or before Pg
Define Pg induced HTN (PIH)
after 20wks in the absence of proteinuria, that returns to nml postpartum 25% will develop preeclampsia or ecclampsia
Define mild preeclampsia
HTN after 20wks plus proteinuria 0.3g/d or >1+ on dipstick (BP readings 6hrs apart in 1 wk), can have edema
Define severe preeclampsia
SBP > 160, DBP > 110, > 5g proteinuria/3+ on dipstick, oliguria < 500ml, HA, scotomata, pulm edema, cyanosis, RUQ pain, hepatic dysfxn, thrombocytopenia, IUGR
Define ecclampsia
grand mal seizure w/preeclampsia, most cases occur w/in 24hrs
What is the workup for HTN?
CBC, liver panel, coags, 24hr urine, CrCl, urine protein. Fetus: US, Biophysical profile/non stress test (mov’t, fluid vol, HR, tone, breathing)
What is the tx for chronic HTN?
meds only if SBP > 150 or DBP > 100. Labetolol, methyldopa, nifedipine
What is tx for preeclampsia?
rest, biophysical profile 2x’s/wk, US q 3 wks, daily kick cts (10+ per hr after eating), hospitalization, induction after 37wks, prophylactic tx MgSO4 for severe preeclampsia
What is tx for eclampsia?
hospitalization, daily labs/fetal monitoring, labetolol or hydralazine to reduce DBP < 100mmHg, MgSO4 for seizure prevention/abortion, induction after 34wks
What is HELLP syndrome?
Hemolytic anemia, Elevated liver enzymes, Low Platelets, in 3rd trimester
What are sx’s of HELLP syndrome?
malaise, HA, N/V, epigastric pain, RUQ pain
What is tx for HELLP?
hospitalize, deliver, fresh frozen plasma transfusion, MgSO4, antihypertensives
What is PROM?
premature rupture of membranes: term is 37wks, preterm PPROM < 37wks (leading cause of neonatal morbidity/mortality)
How do you Dx PROM?
Ntirazine pH test (amniotic fluid is alkaline–turns blue), ferning on microscope slide, use STERILE speculum, no digital exams!
