Pregnancy and HTN Flashcards
What is the definition of gestational HTN?
> /= 140/90 mmHg on at least 2 separate readings at least 4-6 h apart
What does preeclampsia and HTN increase your risk for?
- risk factor of future CV and metabolic disorders
- preterm delivery
- stoke
- seizures
- death
What are high risk factors for gestational HTN?
- chronic HTN
- CKD
- HTN previous pregnancy
- DM (1 and 2)
- autoimmune diseases
What are the moderate risk factors for gestational HTN?
- age >40
- 1st preganacy
- multiples
- BMI>35
- family hx of preeclampsia
What are s/s of preeclampsia?
- usually asymptomatic
- headahce
- rapid weight gain
- change in vision
- abdominal pain
- edema
What is the dx criteria for preeclampsia?
- > /= 140/90 mmHg on at least 2 separate readings at least 4-6 h apart after 20 weeks
- > 160 or >110
AND
proteinuria >/=300 per 24h urine collection
OR
thrombocytopenia, renal insufficiency, impaired liver function
What is the treatment of uncontrolled severe preeclampsia?
delivery if uncontrolled after 24-48h
What is severe preeclampsia?
> 160/>110
thrombocytopenia
renal insufficiency
impaired liver function
What are treatments to prevent preeclampsia?
- aspirin (low dose) last trimester
- LMWH
- calcium (1g/day)
What are nonpharm tx for preeclampsia and gestational HTN?
- modified bed rest
- Na reduction
- daily BP monitoring
- fetal monitoring
What are pharm tx for preeclampsia and gestational HTN?
- Methyldopa
- Nifedipine ER
- Labetalol
When should pharm tx for preeclampsia and gestational HTN begin?
- BP > 160/110
- chronic/ persistent readings >160/105
What is dosing for Mehtydopa?
250mg 2-4 x daily, titrate as tolerated every 2 days
What are SEs with Methyldopa?
- somnolence
- depression
- orthostatic hypotension
What are SEs with Nifedipine ER?
- flushing
- headache
- peripheral edema
What patients should Labetolol not be used in?
asthma
COPD
What are SEs with Labetalol?
fatigue
decreased HR
hypotension
What are SEs of Hydralazine use in preganay?
- lupus-like syndrome
- fetal heart abnormalities
What is eclampsia?
preeclampsia with seizures
When is eclampsia most common?
3rd trimester or within 48h or delivery
What is given to prevent eclampsia?
magnesium sulfate
What is dosing for magnesium sulfate?
4-6g IV loading dose over 20-30 min
continuous IV infusion of 1-3g/h for 24h post delivery
What are SEs with magnesium sulfate?
confusion
somnolence
respiratory distress
cardiac distress
What is considered preterm delivery?
birth prior to 36.6 weeks
