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