Pre-eclampsia

Question 1

Define pre-eclampsia

Answer 1

HTN AFTER 20 weeks gestation with proteinuria or evidence of end-organ damage

Question 2

Pathophysiology of Pre-eclampsia

Answer 2

? Failure of trophoblast migration & impaired spiral artery remodelling causes impairment to flow and abnormal development of placenta

• relative hypoxia to placenta causes factor release
• factors are toxin to endothelial cells causing HTN and prothrombotic state
• endothelial damage causes protein and H2O leak causes oedema and end-organ damage

Question 3

Signs and Sx of pre-eclampsia

Answer 3

• pitting oedema and HTN
• proteinuria
• headaches
• visual sx
• epigastric pain
• seizures
• IUGR

Question 4

Consequences of pre-eclampsia

Answer 4

• placental abruption
• liver haematoma and capsule rupture
• DIC
• Stroke
• Eclampsia

Question 5

Prevention and Management of Pre-eclampsia

Answer 5

Definitive management is delivery of placenta
BP management with hydralizine or labetalol
Prevention:
-low dose aspirin before 20 weeks
-Calcium supp. (evidence when Ca is low)
-smoking cessation