Pregnancy Flashcards
decrease in svr and increase in arterial compliance is evident by
6 weeks of gestation
Plasma volume in pregnancy
inc 30-50% above baseline
BP in pregnancy
Decrease by 10mmhg below prepregnancy level, nadir in 2nd trimester, gradual inc toward pre pregnancy by term
Cardiac output
increase 30-50%
Heart rate
increase by 15-20 beats per min
Length of kidney
Inc 1-1.5 cm
Renal volume
inc up to 30%
renal blood flow
increase to 80%
GFR
150-200 ml/min, 40-50% baseline
Hgb Crea uric acid pco2 Na Osm
decrease
pH Calcium
increase
new osmotic setpoint in pregnancy
270 mOsn/kg
acid base in pregnancy
respi alk
mediates respi alk response
Progesterone
hormone central to global vasodilatory response specifically to increase in GFR and rbf
relaxin
new onser of hypertension and proteinuria after 20 weeks of gestation
preeclampsia
definitive tx of preeclampsia
delivery of neonate
criteria for hypertension in pregnancy
more than or equal to 140/90 after 20 weeks of gestation on 2 occasions at least 4h apart
more than or equal to 160/105 within minutes
criteria for proteinuria in preeclampsia
More than or equal to 300 mg/24H
protein/crea ratio more than 0.3 mg
dipstick +1
Hallmark of preeclampsia
proteinuria
in the absence of proteinuria, preeclampsia is still considered in patients with new inset htn with any of the ff
thrombocytopenia renal insufficiency impaired lft pulmonary edema cerebral of visual symptoms
threshold for thrombocytopenia in preec
<100k
criteria for renal insufficiency in preec
crea > 1.1 or doubling
sudden inc in woman with chronic htn that was previously controlled or escalation of antihtn to control bp
or
new onset of proteinuria in a whiman with chronic htn or a sudden inc in proteinuria un a woman with known proteinuria before or in early pregnancy
superimposed preeclampsia
oliguria < 500 ml in 24H, persistent headache or visual disturbance, pulmonary edema, epigastric or ruq, elevated lft and thrombocytopenia alone or in hellp
severe preeclampsia
Tx of hus/ttp
plasma exchange
tx of hellp and aflp
supportive care/delivery
generalized swelling and vacuolization of the endothelial cells and loss of capillary space
Glomerular endotheliosis