pre-eclampsia, eclampsia and HELLP Flashcards
pre-eclampsia
new-onset hypertension ( > 140/90 after 20 weeks of pregnancy) and one of
proteinuria
other organ involvement ( renal involvement, liver,neurological )
triad
new-onset hypertension
proteinuria
oedema
complications
eclampsia
IUGR, prematurity
liver involvement
haemorrhage
cardiac failure
high rf
hypertensive disease in a previous pregnancy
chronic kidney disease
autoimmune disease, such as systemic lupus erythematosus or antiphospholipid syndrome
type 1 or type 2 diabetes
chronic hypertension
moderate rf
first pregnancy
age 40 years or older
pregnancy interval of more than 10 years
body mass index (BMI) of 35 kg/m² or more at first visit
family history of pre-eclampsia
multiple pregnancy
risk reduction
women with the following should take aspirin 75-150mg daily from 12 weeks gestation until the birth
≥ 1 high risk factors
≥ 2 moderate factors
mx
NICE recommend arranging emergency secondary care assessment for any woman in whom pre-eclampsia is suspected
women with blood pressure ≥ 160/110 mmHg are likely to be admitted and observed
oral labetalol, nifedipine
delivery of the baby
mx of eclampsia
magnesium sulfate
monitoring of mgso4
urine output, reflexes, respiratory rate and oxygen saturations
mx of respiratory depression due to mgso4
calcium gluconate
how long should treatment continue
treatment should continue for 24 hours after last seizure or delivery (around 40% of seizures occur post-partum)
HELLP
Hemolysis, Elevated Liver enzymes, and a Low Platelet count
features of HELLP
nausea & vomiting
right upper quadrant pain
lethargy
ivg for HELLP
bloods: Hemolysis, Elevated Liver enzymes, and a Low Platelet
treatment of HELLP
deliver baby
