Preeclampsia And Hepatic Rupture Flashcards
Old criteria for mild versus severe preeclampsia?
BP 140/90 with 300 mg proteins/24 hours
versus
BP over 160/110 with 5 g protein/24 hours
Definitions;
- Chronic hypertension
- Gestational hypertension
- Preeclampsia
- Eclampsia
- Severe preeclampsia
- Superimposed preeclampsia
- BP >140/90 before 20 weeks gestation
- Hypertension without proteinuria after 20 weeks gestation
- Hypertension with proteinuria over 20 weeks gestation
- Seizure disorder associated with preeclampsia
- Preeclampsia with associated vasospasm that threatens maternal end organs
- Preeclampsia in a patient with chronic hypertension
Urine dipstick suggestive of protein loss in mild versus severe preeclampsia?
1+ or 2+ versus 3+ or 4+
Underlying pathophysiology of preeclampsia? Cure?
Vasospasm and “leaky vessels” which cause local hypoxemia. Hypoxemia leads to hemolysis, necrosis, and end organ damage
End of pregnancy (Usually delivery)
Complications of preeclampsia?
- Placental abruption or uteroplacental insufficiency
- Eclampsia
- Renal failure
- Hepatic subcapsular hematoma or hepatic rupture
- Coagulopathies
Risk factors for preeclampsia?
- Nulliparity or multigestational
- Extremities of age
- African-American
- History of preeclampsia/family history
- Hypertension
- Chronic renal disease
- Diabetes
- Antiphospholipid
Neurologic symptoms of preeclampsia?
Headache, vision changes/Blindness, seizures, hyperreflexia,
Hematologic signs of preeclampsia?
Hypertension, thrombocytopenia, microangiopathic anemia, coagulopathy
Fetal symptoms of preeclampsia?
IUGR, oligohydramnios, decreased uterine perfusion (late decelerations)
Renal and pulmonary signs of preeclampsia?
Decreased GFR, proteinuria, oligoria
Pulmonary edema
When to deliver regardless of gestational age? Otherwise deliver at what gestational age?
Severe preeclampsia; 37 weeks
When does eclampsia typically sent in?
Just prior to delivery, during labor, first 24 hours postpartum
Tx? When to start treatment? When to stop?
Magnesium sulfate – during labor; stop 24 hours postpartum
Magnesium sulfate – excretion? First sign of toxic effects? Other side effects?
Renal (ensure urine output)
Absence of deep tendon reflexes
Pulmonary edema
Uric acid levels in preeclampsia?
Elevated
