Pre-eclampsia Flashcards
What is pre-eclampsia?
Pre-eclampsia is a pregnancy-related hypertensive disorder characterised by new-onset hypertension and proteinuria after 20 weeks’ gestation.
What are the diagnostic criteria for pre-eclampsia?
Diagnosis involves blood pressure ≥140/90 mmHg and proteinuria ≥0.3 g/24 hours or a protein:creatinine ratio ≥30 mg/mmol after 20 weeks.
What are the typical symptoms of pre-eclampsia?
Symptoms include headache, visual disturbances, epigastric pain, nausea, vomiting, and oedema.
What are the risk factors for pre-eclampsia?
Risk factors include first pregnancy, multiple pregnancy, advanced maternal age, chronic hypertension, diabetes, obesity, and family history of pre-eclampsia.
What is the aetiology of pre-eclampsia?
The exact cause is unclear but involves abnormal placentation, endothelial dysfunction, and an exaggerated inflammatory response.
What is the pathophysiology of pre-eclampsia?
It involves poor placental perfusion due to defective spiral artery remodelling, leading to systemic vascular dysfunction and hypertension.
How prevalent is pre-eclampsia?
Pre-eclampsia affects 2-8% of pregnancies worldwide.
What are the complications of pre-eclampsia for the mother?
Complications include eclampsia, HELLP syndrome, stroke, renal failure, pulmonary oedema, and disseminated intravascular coagulation (DIC).
What are the complications of pre-eclampsia for the fetus?
Complications include intrauterine growth restriction (IUGR), preterm birth, placental abruption, and stillbirth.
What investigations are used to diagnose pre-eclampsia?
Investigations include blood pressure monitoring, urinalysis for proteinuria, blood tests (LFTs, U&Es, platelets), and fetal ultrasound.
What is the role of urinalysis in pre-eclampsia?
Urinalysis detects proteinuria, which is a key diagnostic criterion for pre-eclampsia.
What blood tests are typically performed in pre-eclampsia?
Blood tests include liver function tests, renal function tests, platelet count, and coagulation profile.
How is fetal wellbeing assessed in pre-eclampsia?
Fetal wellbeing is assessed using ultrasound for growth, amniotic fluid volume, and Doppler studies of umbilical artery blood flow.
What is the role of antihypertensive medication in pre-eclampsia?
Antihypertensives like labetalol, nifedipine, or methyldopa are used to control blood pressure and reduce maternal and fetal complications.
What is the definitive treatment for pre-eclampsia?
The definitive treatment is delivery of the baby and placenta, often requiring careful timing to balance maternal and fetal risks.
What is the role of magnesium sulphate in pre-eclampsia?
Magnesium sulphate is used to prevent and treat seizures in cases of severe pre-eclampsia and eclampsia.
What are the indications for immediate delivery in pre-eclampsia?
Indications include severe hypertension, organ dysfunction, eclampsia, HELLP syndrome, or signs of fetal compromise.
What is HELLP syndrome, and how is it related to pre-eclampsia?
HELLP syndrome is a severe complication involving haemolysis, elevated liver enzymes, and low platelets, often occurring with pre-eclampsia.
How is mild pre-eclampsia managed?
Management includes close monitoring of blood pressure, proteinuria, and fetal growth, alongside antihypertensive treatment if needed.
How is severe pre-eclampsia managed?
Severe cases require hospitalisation, frequent monitoring, antihypertensives, magnesium sulphate, and preparation for early delivery.
What is eclampsia?
Eclampsia is the occurrence of seizures in a patient with pre-eclampsia, a life-threatening obstetric emergency.
What are the long-term risks associated with pre-eclampsia?
Long-term risks include increased likelihood of cardiovascular disease, hypertension, and kidney disease for the mother.
How can the risk of pre-eclampsia be reduced?
Risk reduction strategies include the use of low-dose aspirin from 12 weeks’ gestation in high-risk women and optimisation of maternal health.
What is the prognosis for pre-eclampsia?
Prognosis depends on the severity and timing of diagnosis; early recognition and management significantly improve outcomes for mother and baby.
