Pre-eclampsia Flashcards
What is gestational hypertension / pregnancy induced hypertension
New hypertension >20 weeks with no proteinuria
What is pre-eclampsia
Multisystem disorder characterised by hypertension >20 weeks and proteinuria
What is eclampsia
Seizure or convulsive episode caused by PET
High risk factors for pre-eclampsia
Hypertension previously in pregnancy
Chronic renal or autoimmune disease
Diabetes
Chronic HTN
Moderate risk factors for pre-eclampsia
First pregnancy
Aged over 40
BMI >35
FHx of pre-eclampsia
Multiple pregnancies
What is given as prophylaxis if there are risk factors
Aspirin 150mg once a day for 12 weeks until delivery
Complications of hypertension
Maternal death
Intracranial haemorrhage
Acute fatty liver of pregnancy
Eclamptic seizures
Hepatic necrosis / rupture
Pulmonary oedema
HTN in later life
CV disease, CVA, IHD
IUGR
Stillbirth
Prematurity - iatrogenic early birth major cause
Symptoms of pre-eclampsia
Headache
Visual disturbances
Nausea
Abdominal pain
Feeling unwell
Reduced fetal movements
Examinations in pre-eclampsia patients
BP
Abdominal palpation tenderness
Obstetric assessment
Investigations in pre-eclampsia
BP monitoring
Urinalysis for proteinuria and PCR
LFTs, FBCs, urea and electrolytes
Fetal assessment - CTG and US
Treatment options to protect mother
HTN complication monitoring
PET complication monitoring
What is used to treat eclampsia
IV Mg sulfate - given as 4g IV bolus then 1g/hr infusion. Monitoring required
Treatment to protect baby in eclampsia
prolong gestation when safe, but give steroids IM
Drug sto control hypertension in pregnancy
Labetalol, Nifedipine, Methyldopa
Management of pre-eclampsia / eclampsia
Stabilise then deliver the baby if needed
What is HELLP syndrome
Haemolysis, elevated liver enzymes, low platelets.
What is postnatal hypertension
BP might rise for the first few days, often needs continued treatment
What is PLGF test
Placental growth factor to diagnose suspected pre-eclampsia in women who present with HTN in weeks 20-35.
