Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Unit 12 > Pre-eclampsia > Flashcards

Pre-eclampsia Flashcards

1
Q

How long is the human gestation period?

A

40 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does the human gestation period counting start from?

A

The first day of the last menstraul period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the role of the placenta?

A

Allos exchange of material between the foetus and the mother
Allows oxygen and nutrients in
Allows waste products and CO2 out
Seperates maternal and fetal circulations
Embeds into the decidual layer of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the three different types of hypertension in pregnancy?

A

Chronic hypertension
Gestational hypertension
Pre-eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is chronic hypertension in pregnancy?

A

Hypertension before 20w gestation
Hypertension would have been present before pregnancy, is not caused by pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is gestational hypertension in pregnancy?

A

Hypertension newly detected after 20w gestation without proteinuria
Absence of features of pre-eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is pre-eclampsia (PET)?

A

Hypertension after 20w gesation before 6 weeks post delivery with proteinuria
Can damage organs such as kidneys, brain and liver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the diagnostic criteria for pre-eclampsia?

A

Blood pressure above 140/90
Proteinuria

Or BP above 160/110 for severe with proteinuria

Or symptomatic presentations: maternal, organ dysfunction (renal or liver), neurological complications, haematological complications, uteroplacental dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the risk factors for pre-eclampsia?

A

First pregnancy
Previosu history or family history
BMI>30
Multiple pregnancy
Maternal age >40yrs
Pregnancy interval >10yrs
Past medical history of diabets, renal disease, hypertension, PCOS
Autoimmune disease
Antiphospholipid antibody syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does pre-eclampsia develop?

A

Abdnormal development of placenta vessels, particularly spiral arteries.
In healthy pregnancy will dilate to 5-10x their normal size to increase blood flow to fetus.
Pre-eclampsia: Are not as dilated as normal
Results in less blood flow through the placenta
This hypoperfused placenta releases pro-inflammatory cytokines which trigger endothelial cell dysfunction.
Causes systemic vasoconstriction and increased salt retention in the kidney.
Also areas of local vasospams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does pre-eclampsia effect the baby?

A

Lack of nutrients/ocygen in and lack of waste out
Can result in fetal growth restriction, pre-term delivery and even fetal death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does pre-eclampsia effect the mum?

A

Hypoperfused placenta released pro-inflammatory proteins which trugger endothelial cell dysfunction
results in systemic vasoconstriction and salt retention in the kidneys
Causes hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the four different categroies of effects of pre-eclampsia?

A

Glomerular damage
Retina
Liver swelling
Vascular permeability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does pre-eclampsia effect the glomerulus?

A

Vasospams results in glomerular damage
Causes:
Oligouria (less urine)
Proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does pre-eclampsia affect the retina?

A

Vasospams results in blurred vision
Flashing lights
Scotoma (focal blurry spot)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does pre-eclampsia affect the liver?

A

Vasospams causes liver swelling
Elevated liver enzymes
Right upper quadrant/epigastric pain
Nausea and vomitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does pre-eclampsia affect vascular permeability?

A

Vasospasm = Increase vascular permeability
Cause odema in the legs, hands and face
Pulmonary odema can cause shortness of breath and cough
Cerebral odema can cause headaches and seizures

18
Q

What are the immediate complications of pre-eclampsia?

A

Placental abruption - resulting in internal and external bleeding - risk of hemorrhage.
Eclampsia
HELLP Syndrome

19
Q

What is eclampsia?

A

When a person has pre-eclampsia and seizures
- new tonic-clonic seizures
- due to cerebral odema
- majority occur in post-natal period
-maternal mortality rate 1.8%, fetal mortality rate 30%

20
Q

What is HELLP syndrome?

A

Low Platelet - endothelial injury triggers thrombi formation which uses up platelets
Haemolysis - thrombus formation causes tubrulent blood flow destroying rbcs
Elevated Liver enzymes - vasospasm of vessels supplying liver cause liver swelling

21
Q

What investigations should you do for pre-eclampsia?

A

Frequent BP monitoring
Blood tests
Urine dipstick - for proetin-creatinine ratio
Ultrasound - fetal growth and wellbeing, uterine artery blood flow

22
Q

What blood tests should you order to investigate pre-eclampsia?

A

Full blood count
Urean and elctrolyes (kidney function particularly creatinine ratio)
Liver function tests
Uric acid (elevates in severe cases)

23
Q

What prevention can be given for women with a risk of pre-eclampsia?

A

Low dose aspirin from 12 weeks gestation till 36 weeks - given for women with two or more risk factors.
COX-1 inhibitor/anti-platelts - suppressed production of inflammatory proteins and inhibits aggregation of platelets
Reduces pre-eclampsia risk by 15%

24
Q

What predictive blood test can be given for pre-eclampsia?

A

sFlt-1 ; PlGF ratio
Used after 20 weeks in high risk women to predict risk of developing pre-eclampsia.
Predicts short term risk of developing pre-eclampsia in the next 7 days.
Higher indicates risk.

25
Q

How should you monitor for pre-eclampsia?

A

Patient education
Frequent BP checks
Weekly bloods
Serial growth scans (2-4 weekly)

26
Q

What is the location of care for pre-eclampsia?

A

At home is mild and stable
Admission if BP unstable, symptomatic or any signs or fetal compromise or complication

27
Q

What medication can be given for pre-eclampsia?

A

Antihypertensives: labetalol, nifedipine, methyldopa
Seizure prevention: magnesium sulphate for severe PET or if symptomatic

28
Q

How is the derlivery of the baby adapted in pre-eclampsia?

A

May need to be delivered pre-term is any complications, not C-section is only used if vaginal birth is contraindicated.
Most are delivery at 37 - labour is induced
Mother takes priority over fetus

29
Q

What is the definitive treatment of pre-eclampsia?

A

Delivery of the placenta

30
Q

Can common hypertensives be used for pre-eclampsia?

A

No
Ramipril and losartan potassium are contra-indicated

31
Q

How is eclampsia managed?

A

Obstetrics emergency call
IV magnesium sulphate for prevention and treatment
IV antihypertensive (labetalol or hydralazine)
Continuous monitoring of mum and baby
Prompt delivery of fetus (emergency C-section) once mum is stable.

32
Q

What are the long term complications of pre-eclampsia?

A

1 in 6 chance of developing pre-eclampsia in the future
5x rinc risk hypertension
3x in risk stroke
3x in risk major adverse cardiovascular event
Slightly higher risk of end-stage kidney disease.

33
Q

What are the different term dates relating to delivery time? (pregnancy)

A

Term delivery - between 37 weeks and 41weeks+6 days

Pre-term - delivery before 37 weeks

34
Q

What are some statistics that show the prevalence of hypertension in pregnancy?

A

Affects 8-10% of pregnancies
Hypertensive disorders are one of the leading causes of direct maternal deaths in the UK.

35
Q

How does pregnancy normally affect the cardiovascular system?
How does this relate to the presentation of chronic hypertension?

A

Early pregnancy - decreased SVR - normally causes hypotension in early pregnancy
CO slowly increases, does not overcome decrease in SVR until 20 weeks - this is when hypertension that is pregnant induced may occur.

36
Q

What anti-hypertensive medications should be given to treat chronic hypertension and gestational hypertension in pregnancy?

A

Common anti-hypertensives such as ramipiral are contraindicated

Should offer - labetalol hydrochloride (non-selective beta blocker)
2nd - nifedipine - Calcium channel blocker allosteriic
3rd - methyldopa - pro-drug alpha 2 agonist

37
Q

How common is pre-eclampsia?

A

Affects 1-5% of pregnant women

38
Q

What indicates significant proteinuria eligible for pre-eclampsia diagnosis?

A

Protein creatinine ratio over 30.

39
Q

What device can be used to monitor a fetus in the uterus?

A

A CTG machine - monitors heart rate.
Two flat round sensors are placed on baby bump to monitor
Can also detect uterine contractions

40
Q

What is the Birth Reflection services?

A

Offered by NHS trusts when a coplicated pregnancy to delivery occurs
Can be traumatic as most women expect an easy pregnany and unable to process at time.
Example: increased hospitalisation, baby admitted to a neonatal unit
Mam can self-referall, allows to ask midwife or ob doctor questions about pregnancy/deliver, speak to neonatal care unit about baby, is psychological support needed an appointment with a therapist can be arranged.

Unit 12 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions