Pre eclampsia Flashcards
- How much of a problem is it - Pathophysiology (why?) - risk factors - symptoms / care pathway
definition fill in the gaps:
- – onset of ———— after – weeks of pregnancy. With the coexistance of one or more of the following:
- proteinurea
- maternal organ dysfunction
- utero-placental dysfuntion
New
Hypertension
20
Chronic / essential hypertension
- when ?
At booking or before 20 weeks pregnancy
Gestational hypertension
- new or preexisting?
- after – weeks ?
- without ———–
New
20
proteinurea
figures of hypertension
figures of severe hypertension
140/90 to 159/109
160/110+
define eclampsia
Pre eclampsia + onset of seizures
Name some Symptoms
- hypertension
- proteinurea
- visual disturbances
- odema
- frontal headaches
- epigastric pain (upper right quadrant)
- oligoura (reduced urine)
- reduced fetal movements
BUT can be symptomless ( eg still have hypertension and protein urea but nothing else)
% of all pregnancies affected by it
2-8%
Name some risk factors
first pregnancy multiple pregnancy more than 10 years since last pregnancy age 40 + BMI 35+ diabetes family history or history in last pregnancy
what are the programmes fullPIERS + PREP-S used for
theyre 2 risk predicting programmes
Pathophysiology fill in the gaps:
- poor ———- resulting in abnormal development
- Normally the spiral arteries —— and provide lost of —– to fetus - but they dont and instead they become ——-.
- Reduced blood flow to placenta = poorly ——–. this can cause — babies and even fetal death.
- This causes an ———– response and ——— are released into the ——– bloodstream.
- These cause ———– cells in the mothers blood vessels to become dysfunctional and cause ————- ( narrowing) and the kidney to retain more —-. Both causing ———–.
- Restricted blood flow also: damage the kidneys to cause ——— ( low urine) and ———–, blurred vision/flashing lights/scotoma due to restriction to —— in eye and the —– ——- to stretch causing right upper quadrant pain.
- Endothelial dysfuction also leads to development of —— which are tiny blood clots in the vessels. This uses up lots of ——– and damages alot of RBC = ———. together this makes up the HELLP syndrome.
- Endothelial damage also increases vascular ———, which causes water to leak out, causing —–. (legs, hands, feet, headaches, pulmonary shortness of breath)
placentation
dilate, blood, fibrous
perfused, SGA
inflammatory, cytokines, maternal
endothelial , vasoconstriction, salt, hypertension
oligourea, proteinurea , retina , liver capsule
thrombi, platelets, heamolysis.
Haemolysis Elevated Liver enzymes Low Platelets
Permability , odema
apart from the regualar screening, what other further tests can be done?
- 24hr urine output test
- FBC(platelets), urea , electrolytes and uric acid
- LFTs (liver function tests)
- fetal monitoring eg. CTG, USS , growth scans
name some maternal complications of pre eclampsia
- eclampsia
- cebral heamorrhage
- placental abruption (coming away from uterus)
- pulmonary odema ( acute respiratory failure)
- DIC (Disseminated intravascular coagulopathy) blood clots through the body
- HELLP syndrome
can eclampsia present without any history of pre eclampsia ?
is nausea and vomiting a bog concern ?
yes , 44% of fits happen postnatally
yes, this is an emergency
What is the name of the first line of treatment drug used for BP?
Labetalol - works within 5 mins . has contraindications with asthma so
Nifedipine is 2nd choice
What drug is used to treat seizures
Magnesium Sulphate
