Pregnancy complications

Question 1

Pre-eclamptic symptoms?

Answer 1

Headache
RUQ pain
Proteinuria
Edema

Question 2

Magnesium sulfate

Answer 2

Magnesium sulfate is first-line seizure prophylaxis in women with pre-eclampsia or eclampsia and is administered intravenously from the time of presentation to postpartum (up to 24 hours postpartum).

Question 3

Magnesium sulfate toxicity

Answer 3

profound hyporeflexia, oliguria, respiratory depression, and cardiac arrhythmia or arrest.

Question 4

diagnostic criteria for HELLP syndrome:

Answer 4

laboratory evidence of hemolysis (i.e., low Hb and elevated LDH), elevated AST, and low platelets.

Most women also have hypertension and proteinuria, although these are not required for the diagnosis of HELLP.

Abdominal pain due to stretching of Glisson capsule from hepatic swelling is a common symptom.

Question 5

Pathophys pre-eclampsia

Answer 5

Abnormal remodeling of the spiral arteries creates narrow vessels instead of large, high-capacity vessels, which leads to placental hypoperfusion.

This causes the release of vasoactive substances by the placenta into the maternal bloodstream that alter systemic endothelial cell function.

Increased vascular tone (systemic vasoconstriction) raises maternal blood pressure to ensure sufficient blood supply to the fetus, and endothelial lesions and release of procoagulants result in microthrombi. These factors lead to organ ischemia and damage, which can manifest with headaches and visual disturbances as seen in this patient due to vasospasms in the CNS.

Question 6

Antihypertensive treatment in pregnancy

Answer 6

Labetalol, hydralazine

Question 7

Gestational hypertension

Answer 7

pregnancy-induced hypertension with onset after 20 weeks gestation

Defined as a systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg on 2 separate measurements at least 4 hours apart

Question 8

Eclampsia may progress to HELLP syndrome T/F

Answer 8

False.

Preeclampsia may progress to the life-threatening HELLP syndrome

Question 9

Preeclampsia

Answer 9

gestational hypertension with proteinuria, renal insufficiency, thrombocytopenia, evidence of liver damage (e.g., elevated liver enzymes, epigastric pain), pulmonary edema, and/or cerebral edema (headache, visual blurring, vomiting, an altered mental status)

Question 10

Superimposed preeclampsia

Answer 10

preeclampsia that occurs in a patient with chronic hypertension

Question 11

Chronic hypertension

Answer 11

hypertension diagnosed < 20 weeks gestation or before pregnancy

Question 12

HELLP syndrome

Answer 12

a life-threatening form of preeclampsia (HELLP is an acronym: H = hemolysis; EL = elevated liver enzymes; LP = low platelets

Question 13

Eclampsia

Answer 13

severe form of preeclampsia with convulsive seizures and/or coma

Question 14

Risk factors for developing placenta previa

Answer 14

Maternal age >35 years old, multiples (twins etc.),
already had a baby,
drug use: cocaine or smoking,
surgery to the uterus that will leave scarring: fibroid removal, c-section etc.

Question 15

sign and symptoms of placenta previa

Answer 15

Painless bright red bleeding
Normal fetal heart rate
Abnormal fetal position

Question 16

Disseminated intravascular coagulation (DIC) can occur in __________________

Answer 16

Disseminated intravascular coagulation (DIC) can occur in Abruptio placentae. This happens because when the placenta becomes damaged and detaches from the uterine wall, large amounts of thromboplastin are released into mom’s circulation, leading to clot formation and then clotting factor depletion

Question 17

PAINLESS, bright red bleeding?

Answer 17

Placenta previa

Also,
avoid sexual intercourse and douching throughout the rest of the pregnancy

uterus should be soft and non-tender

Question 18

pain and dark red bleeding

Answer 18

abruptio placentae