Preeclampsia

Question 1

17 y.o 38 weeks feeling dizzy with edema and HTN
\+ 24 urine protein collection
1/4 DTRs b/l
platelets down
next move?

Answer 1

induce labor since she is term and has neuro Sx

Tx with cytotec for cervical ripening

Question 2

why do you get edema with pregnancy

Answer 2

uterus pushes on inferior vena cava

Question 3

what is cytotec

Answer 3

misoprostel that causes release of PG

Question 4

Mg Sulfate used for what in pregnancy

Answer 4

seizure prophylaxis

Question 5

what to give in preecclampsia for high BP

Answer 5

hydralazine

Question 6

what to Tx postpartum hemorrhage from preeclampsia

Answer 6

oxytocin

hemabate

Question 7

why not give methergine in preclamptic patient who delivered

Answer 7

causes increase in BP

Question 8

leading cause maternal and prenatal morbidity and mortality WW

Answer 8

preeclampsia

Question 9

risk factors for increased risk preeclampsia

Answer 9

nulliparity
age extremes
chornic HTN
black race
high BMI
DM
FMH preeclampsia
hydatidiform mole

Question 10

Dx of preeclampsia

Answer 10

> 140 or DBP >90 on 2 occasions, after 20 weeks gestation
160 or DBP >110 confirmation in minutes
and
proteinuria >0.3 grams or protein/Cr ratio >0.3
(dipstick 1+)

Question 11

what are indications of severe preeclapmsia disease

Answer 11

Sx CNS
hepatic abnormality
severe BP elevation

Question 12

patient with HTN but no proteinuria… what other signs suggest preeclampsia

Answer 12

low platelets
serum Cr >1.1
liver enzymes at least 2x
pulmonary edema
cerebral of visual Sx

Question 13

mild preeclampsia

Answer 13

BP on 2 occsasions was elevated
or had proteinuria
no end organ damage

Question 14

early onset preeclampsia

Answer 14

<34 weeks

Question 15

late onset preeclampsia

Answer 15

> 34 weeks

Question 16

indications for delivery in preeclampsia

Answer 16

nonreassuring fetal heart status
ruptured membrane
uncontrollable BP
oligohydramnios
severe growth restriciton
oliguria
pulm edema
shortness of breath or chest pain with O2<94% on RA
persistent HA
RUQ tenderness (liver)
development of HELLP

Question 17

what should Cr levels do in pregnancy

Answer 17

go down

Question 18

maternal complications preeclampsia

Answer 18

placental abruption
acute renal failure
cerebral hemorrhage
hepatic failure or rupture
pulm edema
DIC
progression to eclampsia

Question 19

begining signs of HELLP

Answer 19

HTN and preeclampsia

Question 20

what anti HTN do you give to severe preeclampsia

Answer 20

labetolol– only if no CHF< asthma, brady
hydralazine
nifedipine

Question 21

what does nifedipine do in pregnancy

Answer 21

block contractions

Question 22

when do give corticosteroids in preeclamptic patient

Answer 22

when <34 weeks

Question 23

when is delivery indicated in preeclampsia

Answer 23

if severe >34 weeks
want 37 (best)

Question 24

prevention preeclampsia

Answer 24

daily low dose aspirin after 1st trimester
weight loss
increased exercise

Question 25

fetal complcations preeclampsia

Answer 25

prematurity complications
uteroplacental insufficiency
oligohydramnios

Question 26

eclampsia

Answer 26

seizure in face of preeclampsia

Question 27

eclampsia occurs when in pregnancy

Answer 27

antepartum, intrapartum and postpartum

Question 28

common presenting Sx of eclampsia in post partum pregnancy

Answer 28

HA, SOB and blurry vision

Question 29

tx eclampsia

Answer 29

ABCs
Tx seizures with only Mg SO4 IV
control BP
STABILIZE mother!!!
delvier fetus
post partum control