Preeclampsia Flashcards
What does epidural anaesthesia do to blood pressure?
Drops it
What is the only cure for preeclampsia?
Delivery
After what gestation can you consider same day delivery in preeclampsia?
34 weeks
Do you continue hypertensive treatment in labour?
Yup
What is Preeclampsia?
condition seen after 20 weeks gestation characterised by pregnancy-induced hypertension in association with proteinuria (> 0.3g / 24 hours).
What are the potential problems associated with preeclampsia?
- fetal: prematurity, intrauterine growth retardation
- eclampsia
- haemorrhage: placental abruption, intra-abdominal, intra-cerebral
- cardiac failure
- multi-organ failure
What are some moderate risk factors for developing preeclampsia??
- 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
What are some high risk factors for preeclampsia?
- 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
Features of severe preeclampsia?
- hypertension: typically > 170/110 mmHg and proteinuria as above
- proteinuria: dipstick ++/+++
- headache
- visual disturbance
- papilloedema
- RUQ/epigastric pain
- hyperreflexia
- platelet count < 100 * 106/l, abnormal liver enzymes or HELLP syndrome
What do high risk mums get?
Aspirin 75mg OD from 12 weeks until both
Normal physiological changes in BP in pregnancy?
Falls in the first trimester
Continues to fall until 20-24 weeks
after this increases to pre pregnancy levels by term
definition of HTN in pregnancy?
systolic >140 or diastolic >90
What is pre-existing hypertension defined as?
A history of hypertension before pregnancy or an elevated blood pressure > 140/90 mmHg before 20 weeks gestation
No proteinuria, no oedema
What is PIH/gestational HTN defined as?
Hypertension (as defined above) occurring in the second half of pregnancy (i.e. after 20 weeks)
No proteinuria, no oedema
What is prognosis for gest HTN?
Resolves following birth, typically after a month
at incr risk of future preeclampsia or htn in later life
