Pre-eclampsia

Question 1

1. What is the commonest cause of iatrogenic prematurity?

2. What are the three diagnostic values for hypertension in pregnancy.

Answer 1

1. Pre-eclampsia
2. two readings >140/90
   one reading >160/110
   >30/15 higher than first trimester pregnancy.

Question 2

1. What is PIH?
2. What are the three major clinical features of pre-eclampsia?
3. What is the difference between early/late pre-eclampsia?

Answer 2

1. Pregnancy induced hypertension, hypertension sub to pre-eclampsia.
2. Hypertension, Proteinuria, Oedema
3. Early- <34 weeks, Late >34 weeks.

Question 3

1. Describe the pathogenesis of pre-eclampsia?

2. What does the abbreviation HELLP stand for?

Answer 3

1. Abnormal placental perfusion that leads to the maternal syndrome.
2. Haemolysis, Elevated Liver enzymes, Low Platelets.

Question 4

1. How might pre-eclampsia be predicted?
2. A 150mg dose of _________ is given to women who are at high risk of pre-eclampsia.
3. _______ ________ and ______ are assessed in all women as part of routine antenatal care to exclude pre-eclampsia.

Answer 4

1. Maternal Uterine Artery Doppler at 20-24 weeks.
2. Aspirin.
3. Blood pressure, urine

Question 5

1. Identify three drugs used in primary treatment of pre-eclampsia.
2. Two second line treatments?

Answer 5

1. Methyldopa, Labetalol, Nifedipine.

2. Hydralazine, Doxazocin.

Question 6

1. Identify the one and only cure for Pre-eclampsia.

2. Define eclampsia

Answer 6

1. Birth of the child

2. Tonic-clonic (grand-mal) seizure occuring with features of pre-eclampsia.

Question 7

1. How do you treat eclampsia?

Answer 7

1. Control BP with IV Labetalol or IV Hydralazine, Control seizures with IV Magnesium sulphate (diazepam if persists), Maintain fluid balance, Birth for cure.