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Conditions - Reproduction > Pre-Eclampsia (PET) > Flashcards

Pre-Eclampsia (PET) Flashcards

1
Q

What does PET (in repro terms) stand for?

A

Pre-eclamptic Toxaemia

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2
Q

What is pre-eclampsia? [General Definition]

A

NEW hypertension
AFTER 20 weeks gestation
in association with SIGNIFICANT PROTEINURIA,

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3
Q

What is the diagnostic definition of Pre-Eclampsia?

A
  • Mild hypertension during pregnancy on two occasions more than 4 hours apart.
    OR
  • Moderate to Severe Hypertension

AND
Proteinuria >300 mgms per 24 hours.

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4
Q

What blood pressure suggests hypertension?

A

Over

130/80

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5
Q

What are some physiological risk factors of pre-eclampsia? (6)

A
  • First pregnancy
  • History of Hypertension
  • History of Renal Disease
  • History of Diabetes
  • History of pre-eclampsia
  • High BMI (>35)
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6
Q

What are some risk factors for pre-eclampsia that can be illicited from history? (4)

A
  • Multigravida
  • Family History of pre-eclampsia.
  • Very young or very old
  • Over 10 years since last pregnancy
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7
Q

What is the main fetal complication assocaited with pre-eclampsia?

A

Impaired placental perfusion.

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8
Q

What are some maternal complications associated with pre-eclampsia? (7)

A
  • Eclampsia (seizures)
  • Pulmonary Oedema
  • HELLP
  • Renal Failure
  • Cardiac failure
  • Stroke
  • DIC (disseminated intravascular coagulation)
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9
Q

What does HELLP stand for?

A

Haemolysis
Elevated Liver-enzymes
Low Platelets

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10
Q

Are all women symptomatic for pre-eclampsia?

A

No!

Most women are actually asymptomatic.

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11
Q

What are the symptoms of pre-eclampsia? (Think CHEERSS PVPV)

A 
Clonus
Headache
ECLAMPTIC CONVULSIONS
Epigastric pain and tenderness
Reduced urine output
Swelling (suddenly)
Severe Hypertension (& +++ proteinuria)

Papillodema
Vision Blurring
Pain below ribs
Vomiting

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12
Q

What biochemical abnormalities do we expect to see in pre-eclamptic women?

A 
↑ Liver Enzyme
↑ Bilirubin
↑ Urea
↑ Creatinine
↑ Urate
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13
Q

What haematological abnormalities do we expect to see in pre-eclamptic women>

A

↓ Platelet
↓ Hg

Signs of Haemolysis (jaundice?)
Features of DIC

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14
Q

What is the only CURE for Pre-Eclampsia?

A

Delivery of Baby AND Placenta

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15
Q

What conservative treatment options are available for pre-eclampsia? (4)

A
  • Antihypertensives
  • Close observations
  • Steroids for fetal lung maturity (only if <36 weeks)
  • Consider induction of labour if maternal or fetal condition deteriorates at any time!!
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16
Q

How do we manage Eclampsia (basically seizures)?

A
    • Magnesium Sulphate Bolus *
  • Control blood pressure
  • Take care to avoid fluid overload.
17
Q

What fluid intake rate should we aim for to avoid fluid overload in pregnant women?

A

80ml/hour

18
Q

What IV drugs can we use to control blood pressure in ECLAMPTIC women?

A
  • IV LABETOLOL
  • IV Hydrallazine

(used if BP > 160/110)

19
Q

What are 3 anti-hypertensives used in the conservative management of pre-eclampsia?

A
  • Labetolol
  • Methyldopa
  • Nifedipine

Conditions - Reproduction (13 decks)

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