pre-eclampsia Flashcards
diff between pre-eclampsia and gestational hypertension
gestational hypertension NO proteinuria and ASYMPTOMATIC
pre-eclampsia
new onset hypertension > 20 WEEKS proteinuria OR low platelets abnormal liver enzymes renal impairment
factors that increase risk of preeclampsia include
high maternal age high BMI BP bleeding in T1 pre-conception relationship < 6 months FHx of CVD or pre eclampsia low maternal birth weight
factors that reduce risk of preeclampsia
smoking in 1st trimester
miscarriage same partner
attemt to conceive> 12 months
using clinical risk factors what % of women can be identified
50% but only at a 20% screen positive rate, 1 in 5 women get screened positive, only 50% of those at risk
trophoblast cells line
placental villi - these cells make placental growth factor, relaxes mother’s vessels, can also release anti-angiogenic factors
in Down syndrome PAPPA is
Low!
in second trimester measure AFP Estriol Inhibin A hCG
AFP - made by baby’s liver, can become elevated if placenta is injured
Inhibin and HcG come from
Trophoblastic surface
When things are abnormal what happens to Inhibia A and HCG
Overproduction of those hormones
Multiple Abnormal IPS is rare but has a %? for delivery < 32 weeks?
75% PPV
What does the placenta look like when injured
- small
Thick
areas of poor development
Uterine artery doppler can show ?
Lower blood flow and nourishment to baby
75% of early onset IUGR/PET
How do we maintain acuity in cornea when so avascular?
VEGF1 peripherally produced - SVED - prevents abnormal angiogenesis (suppress angiogenesis, secreted as a soluble receptor)
In severe preeclampsia you have high levels of
sFLT-1 - vasoconstriction, and endothelial dysfunction
anti-angiogenic properties, less growth factor stimulation of endothelium
