Pre-eclampsia Flashcards

1
Q

what

A

new htn >20wks gestatino with end-organ dysfunction, notably proteinuria

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2
Q

why

A

spiral arteries of placenta form abnormally leading to high vascular resistance in these vessels

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3
Q

triad

A

hypertension
proteinuria
oedema

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4
Q

chronic hypertension

A

htn that exists <20wks gestation and is longstanding

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5
Q

pregnancy-induced/gestational hypertension

A

htn occurring >20wks gestation w/o proteinuria

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6
Q

eclampsia

A

seizures occur as result of pre-eclampsia

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7
Q

High-risk factors

A
pre-existing htn 
prev gestational htn 
existing autoimmune condition e.g. SLE
diabetes
CKD
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8
Q

moderate risk factors

A
>40yrs
BMI >35
>10yrs since last pregnancy 
multiple pregnancy 
first pregnancy 
FHx PET
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9
Q

symptoms

A
headache 
blurred vision 
N&V
epigastric pain 
oedema 
reduced UO
brisk reflexes
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10
Q

diagnosis

A
>140/>90
plus any of 
-proteinuria
-organ dysfunction
-placental dysfunction
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11
Q

quantifying proteinuira

A

1+ on dipstick

protein: creatinine ratio >30
albumin: creatinine ration >8

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12
Q

organ dysfunction

A
raised creatinine 
elevated liver enzymes
seizures
thrombocytopenia
haemolytic anaemia
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13
Q

placental dysfunction

A

IUGR

abnormal doppler sudies

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14
Q

placental growth factor

A

protein released by placenta that functions to stimulate development of new blood vessels

in PET levels are low

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15
Q

PET prophylaxis

A

aspirin

given from 12wks until birth to women with

  • single high risk factor
  • 2+ moderate risk factors
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16
Q

Mx gestational hypertension

A
  • aim BP < 135/85
  • admit if BP >160/110
  • wkly urine dipstick
  • wkly FBC, LFTs, U&Es
  • serial growth scans
  • PlGF on one occasion
17
Q

Mx PET - monitoring

A
similar to gestation htn 
also
-scoring systems
-BP monitored every 48hrs
-USS 2wkly
18
Q

Medical mangement PET

A
  1. labetolol
  2. nifedipine
  3. methyldopa

IV magnesium sulphate during labour and 24hrs after
fluid restriction

19
Q

Mx - after delivery

A
  1. enapril
  2. nifedepine or amlodipine (1st line if black african/carribean)
  3. labaetolol or atenolol
20
Q

eclampsia

A

seizures assoc w PET

IV magnesium sulphate

21
Q

HELLP syndrome

A

haemolysis
elevated liver enzymes
low platelets