Pregnancy complications Flashcards

1
Q

Pre-eclamptic symptoms?

A

Headache
RUQ pain
Proteinuria
Edema

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2
Q

Magnesium sulfate

A

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).

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3
Q

Magnesium sulfate toxicity

A

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

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4
Q

diagnostic criteria for HELLP syndrome:

A

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.

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5
Q

Pathophys pre-eclampsia

A

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.

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6
Q

Antihypertensive treatment in pregnancy

A

Labetalol, hydralazine

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7
Q

Gestational hypertension

A

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

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8
Q

Eclampsia may progress to HELLP syndrome T/F

A

False.

Preeclampsia may progress to the life-threatening HELLP syndrome

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9
Q

Preeclampsia

A

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)

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10
Q

Superimposed preeclampsia

A

preeclampsia that occurs in a patient with chronic hypertension

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11
Q

Chronic hypertension

A

hypertension diagnosed < 20 weeks gestation or before pregnancy

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12
Q

HELLP syndrome

A

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

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13
Q

Eclampsia

A

severe form of preeclampsia with convulsive seizures and/or coma

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14
Q

Risk factors for developing placenta previa

A

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.

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15
Q

sign and symptoms of placenta previa

A

Painless bright red bleeding
Normal fetal heart rate
Abnormal fetal position

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16
Q

Disseminated intravascular coagulation (DIC) can occur in __________________

A

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

17
Q

PAINLESS, bright red bleeding?

A

Placenta previa

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

uterus should be soft and non-tender

18
Q

pain and dark red bleeding

A

abruptio placentae