Pre-eclampsia & gestational hypertension Flashcards
Is pre-eclampsia common?
It is indeed
Occurs in 10% of pregnancies world-wide
In what trimester do most eclamptic seizures occcur
3rd trimester
What is the only curative treatment for pre-eclampsia
Delivery of the baby
What is the leading cause of maternal and perinatal mortality & morbidity
Pre-elampsia
(who would’ve thought)
Is their a familial risk for pre-eclampsia
Yes
Is pre-eclampsia associated with increased fetal movements
Nope
Is smoking a risk factor for pre-eclampsia
Oh contraire
It actually reduces the risk lolz
What does pre-eclampsia increases your risk of getting in the future
Chronic hypertension
Does IVF increases your risk of getting pre-eclampsia
Yes it does
What should be used as prophylaxis for pre-eclampsia
Low-dose aspirin
Magnesium sulphate
If a pregnant patient suddenly becomes hypertensice but their urine dipstick is normal, what is the diagnosis
Gestational hypertension
What is the 1st line treatment for hypertension in pregnancy (gestational hypertension)
Labetolol
What are the clinical features of pre-eclampsia in the…
a) face & eyes
b) limbs
c) chest
d) abdomen
e) general
a)
Facial swelling
Scotomata (blind spot)
Photophobia
b)
Oedema
Clonus
c)
SOB
Retrosernal pain
Crackles
d)
Splenomegaly
Tendereness
RUQ pain
Ascites
e)
Bruising
Seizures
Headache
Altered mental state
Those with pre-eclamspia sometimes complain of getting ‘blind spots’, what is the term for this?
Scotomata
What advice should you give to a patient with pre-eclampsia if they are wanting to have another baby
Get them to lose weight
Take low-dose aspirin for 12 weeks prior to delivery
Don’t take statins
Don’t take antihypertensives
Don’t take Vit. C supplements
For sufferes of pre-eclampsia wanting to have another baby, what should you tell them not to take
Statins
Anti-hypertensives
Vit.C supplements
What is the difference between essential and gestational hypertension in women who are pregnant
Essenetial -> occurs before 20 weeks
Gestational -> occurs after 20 weeks
What is essential hypertension also known as
Chronic hypertension
What is the mmHg levels for:
a) mild hypertension
b) moderate hypertension
c) severe hypertension
a) (140-149)/(90-99)mmHg
b) (150-159)/(100-109)mmHg
c) >160/>110mmHg
What is gestational hypertension
Hypertension that is induced by pregnancy, and must occur after 20 weeks of pregnancy and must go away after
What MUST happen for gestational hypertension to be diagnosed
It goes away after
If pregnany ladies get hypertensive, should they be admitted to hospital
Only if it’s severe
For mild hypertension, how often do you:
a) measure BP
b) measure proteinuria via dipstick
a) once weekly
b) each visit
For moderate hypertension, how often do you:
a) measure BP
b) measure proteinuria via dipstick
a) twice weekly
b) each visit
For severe hypertension, how often do you:
a) measure BP
b) measure proteinuria via dipstick
a) 4 times daily
b) daily
What is the definition of pre-eclampsia
Pregnancy induced hypertension and proteinuria
(after 20 weeks)
What is the defintiino of eclampsia
Prgency induced seizures due to hypertension
In what trimester does pre-eclampsia occur
(not when most seizures occur)
2nd trimester
(because it has to occur after 20 weeks you blithering idiot)
What are the 2 ways in which hypertension isdiagnosed in pre-eclampsia
2x episodes of mild hypertension (measured 4 hours apart)
1x episode of severe hypertension
What are the 3 ways in which proteinuria can be diagnosed in pre-eclampsia and what is the result for each of the tests
Urine dispstick protein: >1
Spot urinary protein/creatinine ratio: >30mg/mmol
24hr urine protein collectoin: >300mg/day
Apart from via hypertension and proteinuria, in what other ways can pre-eclampsia be diagnosed
Renal insuffiency
IUGR
What investigations can be done for pre-eclampsia
BP measuring
Urine dipstick
Urine protein/crearine ratio (P:Cr)
24hr urine collection
Renal & liver function tests
Hb
Platelets
Cardtiotocography
Cardiotocograophy is an investigation that can be used for pre-eclampsia, what 2 things are measured
Fetal HR
Uterine contractions
What are the risk factors for pre-eclampsia
Very young/old for maternal age
1st pregnancy
Family history
Obesity
Multiple pregnancies
Diabetes
IVF
SLE
Why is there a famlial risk in pre-eclampsia
As an imbalance of vasoconstrictors and vasodilators can be genetic
What are some of the complications to the mother for pre-eclampsia
Eclampsia
Severe hypertension
Stroke
DIC
HELLP syndrome
What are the complicatoins to the baby in pre-eclampsia
IUGR
Prematurity
Intra-uterine death
Why can complications of pre-eclampsia affect the baby
As it can cause impaired placenta perfusion
What are the treatments for pre-eclampsia
Delivery (C-section or induction)
Labetolol
Methyldopa
Nifedipine
Magnsium suplhate
Steroids (for baby)
How many weeks before delivery would sufferes of pre-eclmapisa wanting to have another baby take low-dose aspirin
12 weeks prior to delivery
What drugs should be stopped if suffers of pre-eclampsia are being treated
ACEis
ARBs
Anti-diuretics
What is HELLP syndrome
A type of severe pre-eclampsia
Can a pregnant woman get HELLP syndrome withoug being hypertensive
Yes
What are the classic signs of HELLP syndrome
Hemolysis (-> anaemia)
Elevated Liver enzymes
Low Platelets (thrombocytopenia)
If a sufferer of pre-eclampsia gets a low Hb count, low liver enzymes and low platelet count- what is the diagnosis
Pre-eclampsia complicated by HELLP syndrome
