Preeclampsia Flashcards
What is preeclampsia?
New hypertension in pregnancy (>140/90) and proteinuria >20/40
What does preeclampsia affect?
Several organs including kidneys, brain, liver, NS
What are the signs and symptoms of preeclampsia?
- New hypertension
- Proteinuria
- Headache +/- visual disturbances
- Epigastric pain
- Sudden oedema in hands/feet/face
- Reduced urine output
What are the 3 main complications of preeclampsia?
- Eclampsia
- HELLP syndrome
- Disseminated intravascular coagulation
What is DIC?
Blood clots throughout the body
What is HELLP syndrome?
- Haemolysis
- Elevated liver enzymes
- Low platelets
What are some possible foetal complications of preeclampsia?
- IUGR
- Oligohydramnios
- Hypoxia
- Placental abruption
- Premature delivery
What medication is given to women with preeclampsia?
Asthmatic +/or Afro-Caribbean = Nifedipine (+ Hydralazine infusion)
Otherwise = Labetalol
What is eclampsia?
Seizures associated with preeclampsia (medical emergency)
What drug is used to treat eclamptic seizures?
Magnesium sulphate
What is the initial management for women having an eclamptic fit?
- Call for help
- L lateral position (if poss)
- High flow O2
- IV access and bloods
What are the doses used for MgSO4?
Loading = 4g over 5 mins
Maintenance = 1g/hr for 24 hours after last fit
Recurrent seizures = 2g bolus after each, then recommence maintenance dose
What bloods should be taken for preeclampsia?
FBC, G+S, Us+Es, LFTs, clotting, Mg levels if needed
What else should be monitored?
- Observations (MEWS)
- Catheterise and fluids
- CTG
- Neuro observations
What should NOT be given in 3rd stage?
Ergometrine
What is the initial dose of Nifedipine?
10mg
What is the initial dose of Labetalol?
200mg
What is important to consider in preeclamptic women during labour?
Keep an eye on risk of fluid overload - strict fluid balance (80ml/hr)
What causes eclamptic fits?
Cerebral oedema
What causes HELLP syndrome?
- Activation of coagulation system = increased fibrin deposits
- Fibrin deposits on blood vessels walls = blood clots and low platelet count
- Destruction of liver cells
What causes epigastric pain?
Vasoconstriction, causing a reduced blood supply to the liver
