preeclampsia

Question 1

Definition of preeclampsia

Answer 1

New onset of hypertension after 20 weeks pregnancy with significant proteinuria.

Question 2

Values for mild hypertension

Answer 2

140-149/90-99

Question 3

Moderate hypertension

Answer 3

150-159/100-109

Question 4

Severe hypertension

Answer 4

160/110

Question 5

How many still births are contributed to by hypertension?

Answer 5

1 in 50

Question 6

How many pregnancies are affected by hypertension? 2

Answer 6

2-8%

Question 7

What does HELLP Syndrome stand for?

Answer 7

Hemolysis, elevated, liver enzymes, low platelets

Question 8

Risk factors for preeclampsia?

Answer 8

Primiparity
10 year age gap
Black british
Proinflammatory
Mum sister aunt
Multiple pregnancy due to larger placenta

Question 9

Symptoms of preeclampsia

Answer 9

Oedema 
Epigastric pain 
blurred vision
frontal headaches
oliguria
hyperreflexia
reduction in fetal movements

Question 10

What needs to be done if suspcious of preeclampsia?

Answer 10

repeat BP readings 2+ 15 mins apart
blood tests- look at liver function
FBC-low platelets
USS
Protein:creatine ratio >30 30mmol
and 24hour urine collection. 300mg protein
Blood tests for: 
Urea, electrolytes, uric acid, raised levels indicate impact on kidney, liver function tests, ALT and AST.

Question 11

How many women get eclampsia?

Answer 11

1-2%

Question 12

Incidence of eclampsia in AN PN or IP?

Answer 12

an 38%
pn 44%
IP-18%

Question 13

how is preeclampsia managed?

Answer 13

To lower BP, IV or oral labetalol, but nifedipine in asthmatics

Question 14

What is used to treat the seizures?

Answer 14

magnesium sulphate

Question 15

How to manage preeclampsia in labour

Answer 15

regular blood pressure monitoring, continued anti hypertensive medication in labour ,magnesium sulphate
continuous fetal monitoring, strict fluid balance, IV access, Active management of the third stage of labour
(without use of ergometrine or syntrometrine)