pre eclampsia Flashcards
what is it
pregnancy induced hypertension with proteinuria and oedema
when does it usually develop
after 20 weeks, resolves within 10 days of delivery
risk factors pre eclampsia severe risk
chronic hypertension, hypertension in previous pregnancy, CKD, DM, autoimmune disease
risk factors moderate risk
1st pregnancy >40 yrs; pregnancy interval >10y, BMI high, FH eclampsia, multiple pregnancy
what should you take if 1 high risk or 2 moderate risk factors
aspirin 75mg from 12th week pregnancy
effects of pre eclampsia
plasma vol decr, incr peripheral resistance, DIC, oedema may be sudden, proteinuria late sign
preventing eclampsia
bp checks and urinalysis; MgSO4, uterine artery Doppler
symptomatic pre eclampsia
headache, chest or epigastric pain, vomiting, increased pulse, visual disturbance- central scomata, shaking, hyperreflexia with clonus, irritability
what is the BP
> 140/90
management- when to admit to hospital
if the bp rises by >30/20 over booking bp, if bp >160/100 or if bp >140/90 + proteinuria or growth restriction- admit to hospital
management in hospital
bp every 2-4 hours, weigh daily, test all urine for protein, monitor fluids, check U&E, LFTs, platelets. CTG
treatment hypertension
labetalol - 200 mg total. alternative hydralazine
fetal risk factors for pre eclampsia
hydatiform mole, multiple pregnancy, placental hydrops
diagnosis pre eclampsia
hypterntension after 20 weeks with one or more of: proteinuria, renal insufficiency, liver disease, neuro problems, haem- DIC, thrombocytopenia, uteroplacental dysfunction
what symptoms can you get from liver disease due to pre eclampsia
epigastric or RUQ pain
what syndrome can you get
HELLP
what does HELLP stand for
haemolysis, elevated liver enzymes, low platelet count
effects of pre eclampsia on the baby
asphyxia, abruption, small babies
what is the only cure
delivery
what is severe pre eclampsia
bp >160/100 with proteinuria or >140/90 with proteinuria and one of other symptoms
treatment severe pre eclampsia
MgSO4 4g IV over 15 mins in 100ml 0.9% saline; catheterise; monitor FHR; delivery
when should baby be kept inside up until
35 weeks if before 34 weeks - monitor well being
if diagnosed after 35 weeks what is the management
labour induced or C section
should pre eclampsia be allowed to exceed term
no as death increases
does pre eclampsia recur in next pregnancy
5% of next pregnancies
features eclampsia
convulsions and coma. preceded by disorientation- restless, twitchy, tonic clonic
treatment eclampsia
MgSO4 4mg over 5 mins maintain for 24 hour (1g/h); second seizure give 2mg
when should you stop MgSO4 in eclampsia
if RR
what can you give if toxic from MgSO4
calcium gluconate
