PB 222: Gestational Hypertension and Preeclampsia Flashcards
Risk Factors for Preeclampsia
Definition: Preeclampsia
A disorder of pregnancy associated with new-onset hypertension, which occurs most often after 20 weeks of gestation and frequently near term.
Although often accompanied by new-onset proteinuria, hypertension and other signs or symptoms of preeclampsia may present in some women in the absence of proteinuria.
Diagnostic Criteria:
Preeclampsia
Cause of RUQ pain in preeclampsia
Periportal and focal parenchymal necrosis, hepatic cell edema, or Glisson’s capsule
In the setting of a clinical presentation similar to preeclampsia, but at gestational ages earlier than 20 weeks, what alternative diagnoses should be considered?
Diagnostic Criteria:
Preeclampsia with severe features
Up to ___% of women with gHTN will eventually develop proteinuria or other end-organ dysfunction consistent with the dx of PEC, and this progression is more likely when the HTN is diagnosed before 32 w.
Diagnostic Criteria:
HELLP
- Lactate dehydrogenase (LDH) elevated to 600 IU/L or more
- aspartate aminotransferase (AST) and alanine aminotransferase (ALT) elevated more than 2x upper limit of normal,
- Platelets count less than 100 x 10^9/L
Definition:
Eclampsia
New-onset tonic-clonic, focal, or multifocal seizures in the absence of other causative conditions (epilepsy, cerebral arterial ischemia and infarction, ICH, or drug use)
Seizures >> severe maternal hypoxia, trauma, aspiration pneumonia
Clinical Risk Factors and Aspirin Use
MgSO4 for seizure ppx: dosage
6 g IV loading dose infused over 20-30 minutes >> 2 g/hr IV maintenance dose
If difficult to establish IV access: 10 g IM loading dose (5 g IM in each buttock) followed by 5 g every 4 hrs
Serum Magnesium Concentration and Toxicities
MgSO4 toxicity treatment
10 mL calcium gluconate 10% solution IV over 3 minutes
+ furosemide IV to accelerate rate of urinary excretion
Antihypertensive Agents used for urgent BP control in pregnancy
