OBSTETRICS

Question 1

Hypertension in a female before 20 weeks of pregnancy is usually due to…

Answer 1

chronic hypertension.

Question 2

For patients with chronic hypertension before 20 weeks of gestation what should be the best management?

Answer 2

Antihypertensive medication such as Labetalol, Nifedipine, or Methyldopa are recommended when systolic blood pressure is above 160 mmHg, or diastolic blood pressure is above 110 mmHg.

Question 3

After 20 weeks of pregnancy, if there are no severe features or proteinuria, then the diagnosis is…

Answer 3

gestational hypertension.

Question 4

In severe gestational hypertension what should be the clinical approach and does it modify labor?

Answer 4

Antihypertensive medication like labetalol, nifedipine, or methyldopa is given and delivery is usually done after 34 weeks.

Question 5

What features diagnosis pre-eclampsia?

Answer 5

After 20 weeks of pregnancy, if there are severe features like headaches, visual disturbances, liver or kidney dysfunction, pulmonary edema, or low platelets, or if there’s proteinuria, then the diagnosis is preeclampsia.

Question 6

What are the subtypes of pre-eclampsia and what are irs features?

Answer 6

Preeclampsia subtypes include eclampsia, which is when seizures develop, and
HELLP syndrome, where H stands for hemolysis, EL for elevated liver enzymes, and LP for low platelets.

Question 7

What criteria indicate delivery in moms with > 34 weeks of gestation and pre-eclampsia?

Answer 7

In pregnancies 34 weeks or further along, delivery is recommended when there are severe features, eclampsia, HELLP syndrome, progressive labor, rupture of fetal membranes, fetal growth restriction, oligohydramnios or a BPP score of 5 out of 10 or lower.

Question 8

What sould be done if a mom is diagnosed with pre-eclampsia with severe features before 34 weeks of gestation?

Answer 8

If preeclampsia with severe features is diagnosed before 34 weeks, the female is monitored, magnesium sulfate is given to prevent seizures, and corticosteroids are given to help mature the fetal lungs.

Question 9

What is the definition of gestational hypertension

Answer 9

New onset hypertension with BP > 140/90. Severe hypertension is when BP > 160/110

Question 10

Risk factors for gestational hypertension are

Answer 10

First pregnancy
Genetic Factors
Gestação gemelar

Question 11

Quais exames devem ser solicitados para uma mulher com hipertensão na gravidez

Answer 11

1. dosagem de proteinúria
2. Enzimas hepáticas
3. Plaquetas
4. Creatinina

Question 12

Quais exames fetais devem ser realizados em casos de hipertensão na gravidez para avaliar bom estado fetal

Answer 12

Biophysical profile/nonstress tests
Measure amniotic fl uid index (AFI
Uterine, umbilical artery doppler velocimetry
Monitor fetal growth signs (placental insufficiency)