Module 08: Hypertension Flashcards
This is a disorder occurring during pregnancy after 20th week of gestation.
HYPERTENSION (occurs in 5% to 10% of all pregnancies)
What is the blood pressure criteria for gestational hypertension?
Elevated blood pressure of 140/90 mmHg.
Does gestational hypertension involve proteinuria or edema?
No, it does not include proteinuria or edema.
When does blood pressure return to normal in gestational hypertension?
AFTER BIRTH
What is mild preeclampsia?
140/90 mmHg or an increase of >30/15 mmHg in two consecutive readings (6 hours apart).
What level of proteinuria is present in mild preeclampsia?
1+ to 2+ on a random urine sample.
What type of edema is common in mild preeclampsia?
Mild edema in the upper extremities and face.
What is the blood pressure threshold for severe preeclampsia?
160/110 mmHg.
What level of proteinuria is present in severe preeclampsia?
3+ to 4+ proteinuria.
What additional symptoms may occur in severe preeclampsia? (OICEHTE)
(A) Oliguria
(B) Increased serum creatinine
(C) Cerebral or visual disturbances
(D) Extensive peripheral edema
(E) Hepatic dysfunction
(F) Thrombocytopenia
(G) Epigastric pain
What distinguishes eclampsia from preeclampsia?
The presence of seizures or coma accompanied with symptoms of pre-eclampsia.
How does maternal age influence the risk of hypertension in pregnancy?
Women over 35 years old and primiparas under 20 years old are at increased risk.
How does race affect the risk of hypertension in pregnancy?
Women of color have a higher risk.
How does socioeconomic status affect the risk of hypertension in pregnancy?
Women with low socioeconomic status have a higher risk.
How does polyhydramnios contribute to hypertension risk?
Excessive amniotic fluid increases strain on the circulatory system.
How does multiple pregnancy affect hypertension risk?
Carrying more than one fetus increases blood volume and pressure.
How does multiparity contribute to hypertension risk?
Women with more than five pregnancies are at higher risk.
How does diabetes mellitus (Type 1 or Type 2) increase hypertension risk?
Increased blood viscosity raises blood pressure.
What preexisting medical conditions increase the risk of hypertension in pregnancy?
(A) History of renal disease
(B) Essential hypertension
(C) Heart disease
How does a history of preeclampsia affect future pregnancies?
Women who had preeclampsia in a previous pregnancy are at higher risk for recurrence.
These are known to invade the myometrium and spiral arteries to facilitate maternal and fetal transfusion.
Villous Cytotrophoblasts
What happens to the spiral arteries during hypertension in pregnancy?
They lose their endothelium and most muscle fibers, making them less resistant and less sensitive to vasoconstriction.
What changes occur in the lumen of the spiral arteries?
The lumen dilates, the trophoblast invades the vessel wall, and muscular/elastic tissue is replaced by fibrinoid material.
How does increased blood volume during pregnancy affect circulation?
It requires more effort to circulate properly, which can lead to endothelial cell injury.
What imbalance occurs between prostacyclin and thromboxane in hypertension during pregnancy?
Prostacyclin (vasodilator) decreases, while thromboxane (vasoconstrictor) increases, leading to high blood pressure.
What systemic response results from endothelial dysfunction?
A systemic inflammatory response disrupts homeostasis, contributing to hypertension and preeclampsia.
What substances increase due to hypertension in pregnancy, leading to vasoconstriction?
Angiotensin and norepinephrine.
(VASOCONSTRICTORS)
How does vasoconstriction affect peripheral resistance?
A: It increases peripheral resistance, leading to high blood pressure and decreased blood flow to body systems.
How does hypertension affect kidney blood flow?
It increases resistance, reducing the glomerular filtration rate.
What happens to the glomerular membranes in hypertension?
They become more permeable, allowing albumin and globulins to escape into the urine, causing proteinuria.
What are the effects of reduced kidney function in hypertension?
(A) Oliguria (decreased urine output)
(B) Decreased creatinine clearance
How does the kidney react to hypertension by altering sodium levels?
It increases sodium retention, thus leading to fluid retention.
How does fluid shift in hypertension contribute to edema?
Fluid diffuses from the bloodstream to interstitial tissues, causing edema formation.
How does hypertension affect blood flow to the pancreas?
It increases blood flow resistance, leading to decreased pancreatic circulation.
What happens when the pancreas experiences ischemia?
It triggers an inflammatory response, causing epigastric pain.
How does hypertension affect blood flow to the eyes?
It decreases blood flow, leading to spasms in the retinal arteries.
What are the complications of retinal artery spasms in hypertension?
(A) R
