PET & Eclampsia Flashcards
1
Q
outline the triad of PET
A
- HT >140/90
- Proteinuria
- 1+ on urinalysis
- >0.3g/L
- Oedema
2
Q
when does it usually occur?
A
> 20 weeks gestation
3
Q
what is eclampsia?
A
grand mal seizures occur as a result of PET
4
Q
pathophysiology of PET
A
failure of trophoblast invasion of spiral arterioles causing uteroplacental ischaemia. Associated with
- widespread endothelial dysfunction
- increased maternal inflammatory response
5
Q
epidemiology?
A
5-10% of all pregnancies
6
Q
risk factors?
A
- High risk
- previous PET
- Pre-existing HT
- chronic health conditions ie CKD, diabetes, auto-immune
- Moderate risk
- age > 40
- BMI > 35
- FH
- first pregnancy
- multiple pregnancy
7
Q
Symptoms?
A
- headache
- blurred vision / visual dusturbance
- nausea & vomiting
- epigastric/RUQ pain
- peripheral / papilloedema
severe PET:
- oliguria
- brisk reflexes
- cerebral / pericardial oedema
8
Q
complications?
A
- renal / liver failure
- eclampsia
- DIC
- HELLP
- severe HT–> haemorrhage/stroke
- pul oedema
- death
- foetus–> IUGR/foetal distress
9
Q
outline HELLP syndrome
A
- Haemolysis
- Elevated Liver enzymes
- Low Platelets
10
Q
Mx for moderate PET
A
- <37 weeks- Conservative
- close monitoring & anti-hypertensives
- Curative= delivery (>37 weeks)
- mag sulphate during labour & 24h after
11
Q
outline choice of anti-hypertensives
A
- Labetolol
- Nifedipine
12
Q
how do you monitor the woman closely?
A
- monitor BP
- monitor urine dipsticks
- monitor symptoms
- do regular bloods: LFT,UE,FBC,Coag
- monitor foetus: CTG / pelvic USS/ umbilical doppler/ foetal movement
13
Q
Mx of severe PET?
A
- Anti-hypertensives + Mag Sulphate
- plan urgent delivery
- if <34 weeks, give steroids
- monitor foetus w/ CTG
14
Q
definition of severe PET
A
- BP >160/110
- proteinuria 3+
clinically: oliguria, brisk reflexes, cerebral/pericardial oedema
15
Q
prophylaxis of PET?
A
if one high risk factor or 2+ moderate risk factors: Aspirin 75mg daily from 12 weeks –> birth
