pre-eclampsia Flashcards

1
Q

what are the risk factors for pre-eclampsia?

A
  • maternal age > 40 years
  • maternal BMI > 30
  • family history
  • parity (more likely in first pregnancy)
  • multiple pregnancy
  • previous PE
  • birth interval > 10 years
  • molar pregnancy/triploidy
  • multiparous women develop more severe disease
  • pre-existing conditions i.e. renal disease, hypertension, DM, CTD, thrombophilias
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2
Q

describe the pathophysiology of pre-eclampsia?

A
  • diffuse vascular endothelial dysfunction w widespread circulatory disturbance
  • classified as early or late
    early: <34 weeks, uncommon, assoc w placental dysfunction
    late: >34 weeks, accounts for 9/10 cases
    stage 1: abnormal placental perfusion (placental ischaemia)
    stage 2: maternal syndrome (anti-angiogenic state assoc w endothelial dysfunction)
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3
Q

what kind of liver disease can predispose a women to pre-eclampsia?

A
  • HELLP syndrome
    : haemolysis, elevated liver enzymes, low platelets

> abnormal liver enzymes
hepatic capsule rupture

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4
Q

how does placental disease affect baby?

A
  • fetal growth restriction
  • placental abruption
  • intrauterine death
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5
Q

what is the clinical presentation of pre-eclampsia

A
  • hypertension
  • proteinuria
  • oedema
    > however women may be asymptomatic at the time of their first presentation
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6
Q

what are some symptoms of pre-eclampsia?

A
  • headache
  • visual disturbance
  • epigastric/RUQ pain
  • nausea and vomiting
  • rapidly progressive oedema
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7
Q

what are some signs of pre-eclampsia?

A
  • hypertension
  • proteinuria
  • oedema
  • abdominal tenderness
  • disorientation
  • hyper-reflexia/involuntary movements/clonus
  • SGA fetus
  • intra-uterine fetal death
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8
Q

what investigations are carried out for pre-eclampsia?

A

bloods: U+Es, serum urate, LFTs, FBC, coag screen
urine: protein:creatinine ratio
CTG
US - fetal assessment

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9
Q

what is the mx for pre-eclampsia?

A
  • low dose aspirin 150mg - may more beneficial in preventing severe early onset pre-eclampsia
    > used for high risk women
    > safe in pregnancy
    > commence before 16 weeks
  • only ‘cure’ for pre-eclampsia is birth
    mother must be stabilised before birth
    consider expectant mx if pre-term
    steroids/magnesium sulphate
    most women delivered within 2 weeks of dx
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10
Q

what are complications of pre-eclampsia?

A
  • eclampsia
  • HELLP syndrome - haemolysis, elevated liver enzymes and low platelets
  • pulmonary oedema
  • placental eruption
  • cerebral haemorrhage
  • cortical blindness
  • disseminated intravascular coagulation (DIC)
  • acute renal failure
  • hepatic rupture
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