Pre-eclampsia Flashcards
define pre-elampsia.
new onset hypertension after 20 weeks + one of: proteinuria, end-organ dysfunction, IUGR of fetus
symptoms of pre-eclampsia?
headache
blurred vision
RUQ/epigastric pain-from stress on liver capsule
clinical signs that may be found in someone in pre-eclampsia?
RUQ/epigastric tenderness
edema (hands, feet, face)
hyper-reflexia, clonus
< symphysiofundal height due to IUGR
pathophysiology of pre-eclampsia
failure of the spiral arteries to invade the myometrium leading to reducing in uteroplacental blood flow. end up with release of PDGF that will cause endothelial dysfunction in the mother
what are risk factors for pre-eclampsia?
high risk: prior preeclampsia, chronic kidney disease, chronic hypertension, diabetes, multiple gestation, autoimmune disease
moderate risk: primigravida, advanced maternal age, obesity
maternal complications of pre-eclampsia?
HELLP syndrome
renal failure
DIC
Eclampsia
cardiac failure (pulmonary oedema)
cerebrovascular hemorrhage
eclampsia
fetal complications of preeclampsia
abruptio placentae
IUGR
intrauterine death
investigations commonly performed in PET?
blood pressure
urine dipstick
24 hour urine collection
urine protein:creatinine ratio
bloods: FBC, LFTs, U and E, coagulation profile, LDH, Urate
define HELLP syndrome
hemolysis wth eleavted liver enzymes and low platelets
how can HELLP syndrome present?
epigastric/RUQ pain
nausea and vomitting
tea-coloured urine (hemolysis)
management situations with pre-eclampsia
ensure vitally stable
admission to HDU
start monitoring: vitals, BP and HR every 15 minutes, urine output and fluid balance, neuro assemensts
IV magnesium sulfate: prevention of seizures
IV antihypertensives
2 causes of abdominal pain in patient with preeclampsia ?
HELLP syndrome
placental abruption
causes of acute breathless in PET?
pulmonary edema/hemorrhage
what medication is given for prophylaxis in patients with high risk of developing preeclampsia
aspirin 75 mg PO OD starting at 12 weeks
