PRE-ECLAMPSIA

Question 1

Pre-eclampsia is characterised by……

Answer 1

Hypertension and Proteinuria

Question 2

……………….. and ……………. are essential in the monitoring of pre-eclampsia together with the recommended investigations

Answer 2

BP monitoring every 4 hours
and
Daily weight of the patient

Question 3

Target BP in pre-eclampsia

Answer 3

Not less than 140/90

Question 4

Why isn’t the BP lowered below the target in pre-eclampsia

Answer 4

It may cause foetal distress due to reduced perfusion

Question 5

Investigations done in Pre-eclampsia

Answer 5

FBC
RBG
LFTs
BUE and creatinine
Urinalysis and Culture
Ultrasound scan
Daily urine protein assesment
Serum uric acid

Question 6

Signs of mild pre-eclampsia

Answer 6

BP of 140/90 to 159/109
Proteinuria of 1+/2+
Pedal edema

Question 7

Signs of severe pre-eclampsia

Answer 7

BP of 160/110 or higher
Proteinuria of 3+/4+
Pedal or generalized edema

Question 8

Treatment objectives in pre-eclampsia

Answer 8

To reduce BP but not less than 140/90
To prolong pregnancy as long as possible
To prevent fœtal distress
To prevent or treat any complications that might arise
To prevent eclampsia

Question 9

Why is prolonging the pregnancy as long as possible a treatment objective in pre-eclampsia

Answer 9

To allow the fœtus to grow and mature for delivery

Question 10

Patients with pre-eclampsia are advised to lie on their side and not on their backs to prevent…..

Answer 10

Supine hypotension or Aortocaval Compression syndrome

Question 11

At which BP is it necessary to initiate pharmacological management of pre-eclampsia

Answer 11

SBP above 150 or DBP above 100 or Symptoms of imminent eclampsia

Question 12

Pharmacological management of mild pre-eclampsia

Answer 12

Methyldopa PO 250-500mg 8-12 hourly max of 2g daily

Nifedipine retard PO 10-40mg 12 hourly

Nifedipine sustained release 30-60mg daily

Question 13

Medical disorders associated with pre-eclampsia

Answer 13

Kidney disorders
Diabètes mellitus
Polycystic ovaries
Chronic hypertension