Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obestetrics > Pre-Eclampsia > Flashcards

Pre-Eclampsia Flashcards

1
Q

Degrees of pre-eclampsia

A

Follows HTN

Mild: 140/90-149/99

Mod: 150/100-159/109

Severe: 160/110

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Admit to hospital for pre-eclapmsia

A

Mild

Mod

Severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treat Pre-eclampsia?

A

Mild: no

Moderate: oral labetalol (150/80-100)

Severe: PO labetalo (150/80-100)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Measure BP in pre-eclampsia

A

mild: 4+/day

Mod: 4+/day

Severe: >4 depends on circumstances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Test for proteinuria in pre-eclampsia

A

Mild: no need to repeat quantification of proteinuria

Moderate: do not repeat quantification of proteinuria

Severe: do not repeat quantification of proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Blood test in pre-eclampsia

A

Kidney fucntion

electrolytes

FBC

LFT + bili

Mild 2/wk

mod/sev: 3/wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diagnosis of pre-eclampsia

A

BP >140/90

Proteinuria (PCR >30)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antenatal Mx of Pre-eclampsia

A

Treat htn: Labetalol (nifedipine/methyldopa) 2nd line: hydralazine, amlodipine, doxazocin

Regular foetal surveillence (growth, liquor, UA doppler)

Steroids if delivery <34 weeks

do NOT deliver unless mother stable

avg. Dx to delivery = 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fetal Monitoring in Pre-eclampsia

A

Growth scans and UA dopplers (PET)

Mild/mod GHTN: USS FG, amnio vol., UA doppler if Dx <34wks, CTG only if abnormal. 15% will -> pre-eclampsia

Severe GHTN or Pre-eclampsia:

  • CTG at Dx, if normal 1 weekly, repeat if:
  • RFM, PVB, Abdo pn, det. maternal condition
  • if planning conservative Mx then just fo USS FG, AFVA, UADV

High risk of Pre-eclampsia:

  • USS F, AFVA, UADV at 28-30wks

repeat 4 weeks later if:

  • Hx: severe pre-eclampsia, PE req. birth <34wk, PE w/SGA, IU death, abruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PET

A

Pre-eclamptic toxaemia

Cx of pre-eclampsia

Bilateral notching and increased pulsatility index at 24wks predicts PET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Timing of birth in Pre-eclampsia

A

Manage conservatively until 34wk

Offer birth to pts w/PE <34wks and after CS if:

  • severe refractory HTN, indications

Recommend birth to pts w/PE + sev. HTN once BP controlled

Offer to pt w/mild/mod PE at 34-34+6

Recommend birth within 24/48hrs for women w/PE and mild/mod htn after 37wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indications for delivery in pre-eclampsia

A

Uncontrollable BP

Rapidly worsening biochem/haematology

Eclampsia

Maternal Sx

Foetal distress (sev. IUGR/ red. UA EDF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Intrpartum care in pre-eclampsia

A

Continuous CTG

Regional anaesthesia helps control BP

Operative birth if refractory HTN

AVOID ergometrine

BP measurements hourly if mild/mod, cont. if sev.

Continue antenatal anti-htn

do NOT routinely limit the duration of second stage in women:

-mild/mod htn or sev. in target range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Medical Mx of Severe HTN or pre-eclampsia in critical care setting

A

IV MgSO4 given to pt. w/ sev htn/PE who has Hx eclamptic fit

Consider MgSO4 in critical care if birth <24hrs

Continue MgSO4 for 24hrs after last seizure or following delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MgSO4 Risk, counter?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of Severe pre-Eclampsia

A

Sev. htn and proteinuria

Mild/mod htn AND one of:

  • severe headache, visual disturbance, papilloedema
  • Severe pain below the ribs
  • clonus
  • Liver tenderness
  • HELPP
  • plts <100
  • abnormal LFT
17
Q

Dosing of MgSO4 in severe htn/PE in critical care

A

loading 4g IV/5mins

infusion 1g/hr 24hrs

Recurrent seizure: 2-4g/5min

Monitor: urine output, reflexes, RR, O2 sats

18
Q

Mx Women w/severe htn in critical care during pregnancy or after birth immediately with:

A

Labetalol PO/IV

Hydralaine (IV)

Nifedipine PO

19
Q

Response to treatment with anti-htn after birth in women with severe htn in a critical care setting

A

Ensure BP dalls

Identify adverse effects

Modify treatment

20
Q

If pt. in critical care w/sev htn what to consider if delivery likely <36 weeks

A

betamethasone

21
Q

Postnatal investigation, monitoring and treatment for pre-eclampsia

A

BP: 4/d as in-pt., once d3-5, then alternate days until normal

Commence anti-htn if >150/100

Ask about sev. headache and epigastric pn when BP measured

Pts who took anti-htn and gave birth: continue, consider reduce if <140/90, reduce if <130/80

Stop methyldopa 2d after birth

22
Q

Transfer to community care after pre-eclampsia

A

No Sx of PE

BP <149/99

Bloods stable/improving

Care plan: freqency of BP monitoring, threshold for red/stop Rx, indications for referral, self monitoring

Medical review if still on anti-htn 2wks after community transfer

23
Q

Breastfeeding in pre-eclampsia

A

Avoid duiretics while bf/expressing

Not recommened: ARB, ACEi (2 exceptions), amlodipine

Safe: labetalol, nifedipine, enalaprin, captopril, atenalol, metoprolol

24
Q

Advice and FU care for pre-eclampsia

A

GHTN and PE increase risk of mother getting HTN later

Increased RR of kidney dx but risk small if no proteinuria/htn at 6-8wk review

25
Q

Risk in future pregnancies if GHTN

A

GHTN 16-47%

PE 2-7%

26
Q

Risk in future pregnancies if a woman had PE

A

GHTN: 13-53%

PE: 16% (higher if sev./HELLP)

27
Q

Antenatal summary for PE

A
  1. Treat HTN (labetalol, nifedipine, methyldopa)
  2. Regular surveillance (growth, liqour, UA, blood flow)
  3. Steroids if delivery <34wk
  4. do NOT deliver unless mother stable
28
Q

Severe PE summary

A

Transfer HDU unless in active labour

stop anit-coag

inform: labour ward coord, consultant obs., anaesthetist

MEOWS/HDU chart BP every 15min

PET bloods 4-12hrly

29
Q

Postnatal sumary for Pre-eclampsia

A

If severe PET observe in HDU for 24hr (fluid, BP, symptoms)

consider LMWH within 6hr delivery

BP may peak at d3-6

avoid NSAIDs

BP Rx: atenolol, nifedipine, amlodipine

Recurrence: 15% riskon average

30
Q

PACES Counselling of Pre-eclampsia

A

RF: Hx (G)HTN, multiple preg., DM, kidney dx, first pregnancy, obesity, ><20>35, FHx, PCOS

Admission required until BP controlled

Risks: early del., reduced placental func., IUGR, risk to mother)

2-8% of pregnancies

Rx: labetalol

BP closely monitored: 4/d then 2/3 per week

Early delivery may be necessary

Once discharged: BP+CTG 2/wk and bloods

Risk of recurrence 15%

Obestetrics (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions