Module 6 : Hypertension in Pregnancy Flashcards
what is chronic or essential hypertension
- hypertension discovered before pregnancy or before 20 weeks
what are the secondary causes of hypertension in pregnancy when hypertension is seen before pregnancy
- renal disease
- endocrine disorders
- neurologic disorders
what is gestational hypertension
- occurs after 20 weeks
- blood pressure above 140/90mmHg
- some patients are asymptomatic
- no presence of proteinuria
what can gestational hypertension lead to
- pre eclampsia
when does gestational hypertension usually resolve
- within first 12 weeks of giving birth
what is pre eclampsia caused by
- caused by prostaglandin abnormalities
what are prostaglandins
- the contraction and relaxation of smooth muscles
- the dilation and constriction of blood vessels
- control of blood pressure
- modulation of inflammation
why does pre eclampsia occur
- abnormal development of the blood vessels of the placenta early in pregnancy
- trophoblast does not invade the decidua properly and spiral arteries remain small and rigid so not enough flow tot eh fetus and the oxygen supply to fetus reduced
when does pre eclampsia occur
- after 20 weeks
what are the symptoms fo pre eclampsia
- blood pressure above 140/90
- proteinuria
- edema
- rapid wait gain
what must occur in order for pre eclampsia to be diagnosed
- high blood pressure present with one or more of the other symptoms
what resolves pre eclampsia
- delivery
what does HELLP stand for
Hemolysis
Elevated Liver enzymes
Low Platelets
what is HELLP syndrome
- a severe variant of of pre eclampsia
+ maternal hypertension
+ edema
+ abdominal pain due to hepatic hemorrhage
what is eclampsia
- onset of seizures in a women with pre eclampsia
what are the characteristics of eclampsia
- seizures
- coma
- bleedong
- headaches
- blurred vision
- maternal death
- fetal death
what is the sonography role in hypertension
- IUR
- preterm layer
- placental abruption
- placental infarcts
- oligohydramnios
- decreased placental maturation
- fetal demise
what low level of first trimester screen test is considered a marker for pre eclampsia
- PAPP A
what doppler test is used to screen for women at an increased or high risk for pre eclampsia
- doppler indicies for the uterine artery
what are the abnormal findings of the uterine artery dopplers
- increased resistance to blood flow
- resistance should fall with advancing gestation so high resistance indicates increased vascular resistance and poor uterine circulation
what is the proper protocol for hypertension in pregnancy
- BPP
- growth
- doppler of umbilical artery
what does the doppler look like in the umbilical artery with hypertension
- high resistance
- low or reversed diastolic flow
- PI preferred measurement
what does doppler look like in the MCA with hypertension
- low resistance
- increased diastolic flow
what does the doppler look like int eh ductus venosus with hypertension
- reversal during atrial contraction
what is the treatment for hypertension
- bed rest
- medication for hypertension
- increased monitoring of mother and fetus
- delivery is the only way to reverse the process
