Pre-Eclampsia + HTN Flashcards
What is pre-eclampsia?
HTN leading to maternal end-organ failure (proteinuria)
What should be given to prevent development of pre-eclampsia?
150mg aspirin
Combo with good HTN management
What drugs are given to control HTN and prevent eclampsia?
HTN 1. Labetalol - B + A blocker OR 1. Nifedipine - black African/Caribbean 2. Hydralazine IV - potent vasodilator
Can be used together in serious cases
IV Magnesium Sulphate
What is HELLP syndrome?
complication of pre-eclampsia
Haemolysis
Elevated liver enzymes
Low Platelets
What is the pathophysiology of pre-eclampsia?
Why does it happen?
Lacuna in the placental development aren’t big enough -> raised vascular resistance in spiral arteries and poor placental perfusion -> oxidative stress -> systemic inflammation
Unknown cause - pathophysiology is poorly understood
Who is most at risk of developing pre-eclampsia
Older women Diabetics Pre-pregnancy HTN Obesity Multiple pregnancies First pregnancy Previous pre-eclampsia Existing autoimmune condition CKD
Pre-eclampsia is routinely checked for how?
- BP
- Urine dipstick
- ask about symptoms
What is a diagnosis of pre-eclampsia?
HTN (>140/90 twice) or >160/110 once
+ 1 of..
- Proteinuria
- End organ failure
- Placental dysfunction
What is the only cure?
Birth
Considered early if:
- no control of BP
- eclampsia
- foetal compromise
Why must you fluid restrict the patients?
Prevent pulmonary oedema - leading cause of death
Would you admit a patient with BP 140/90 and proteinuria (++)?
When would you also admit?
Yes - minimum req to admit or stupid high BP
- signficant symptoms
- abnormal biochem
- uPCR >30
- sign of foetal compromise
If a patient is discharged from hospital but still has moderately high HTN. What should be done?
Community HTN measured every 2 days
Why would a patient present with epigastric pain?
Due to liver swelling
