pfe eclampsia

Question 1

pre eclampsia presentation

Answer 1

high BP >140/90
proteinuria of 300 mg/24hrs PCR >30mg/mmol, after 20 weeks gestation
oedema
- Headache
- Visual blurriness
- Nausea

severe if >160/110

Question 2

risk factors pre eclamspia

Answer 2

• Previous hypertension in pregnancy
• CKD
• Autoimmune disease
• T1DM/T2DM
• Chronic hypertension
• First pregnancy
• Family history of pre-eclampsia
• Multiple pregnancies
• More than 40 years of age
• BMI >35

Question 3

HELLP syndrome

Answer 3

haemolysis
elevated liver enzymes
low platelets

Question 4

complications of pre eclampsia

Answer 4

• Eclampsia (Seizures)
• Severe hypertension
• HELLP (Haemolysis, Elevated liver enzymes, Low platelets)
• Disseminated intravascular coagulation
• Renal failure
• Pulmonary oedema, Cardiac failure

foetus-
- Impaired placental perfusion leading to:
- Intrauterine growth restriction (IUGR)
- Foetal distress
- Prematurity

Question 5

investigations

Answer 5

BP >140/90
bloods- LFTs, thrombocytopenia
urine dipstick- protein
CTG
umbilical artery doppler

Question 6

management pre eclampsia

Answer 6

aspirin from 12 weeks until birth
admit if BP>160/100
labetolol, nifidepine 2nd line if patient asthmatic or contraindicated, methyldopa 3rd line
corticosteroids and IV magneisum as per preterm birth guidlines

aim for delivery within 48 hours of 37 weeks gestation

Question 7

management eclampsia

Answer 7

ABC
4g Iv magnesium sulphate bolus then 1g/hr Iv continued for 24 hr post delivery
Lower BP by giving Labetalol gradually
If Severe Pre-eclampsia (BP >160/110) — IV labetolol and hydralazine are given
emergency lower segment C section