Pregnancy: Hypertension Flashcards
What happens to blood pressure during the first trimester of pregnancy?
Blood pressure usually falls in the first trimester, particularly the diastolic, and continues to fall until 20-24 weeks.
What occurs to blood pressure after 20-24 weeks of pregnancy?
After this time, blood pressure usually increases to pre-pregnancy levels by term.
What did NICE publish in 2010 regarding hypertension in pregnancy?
NICE published guidance on the management of hypertension in pregnancy and recommendations on reducing the risk of hypertensive disorders.
What should women at high risk of developing pre-eclampsia do?
Women at high risk should take aspirin 75mg od from 12 weeks until the birth of the baby.
How is hypertension in pregnancy defined?
Hypertension in pregnancy is defined as systolic > 140 mmHg or diastolic > 90 mmHg, or an increase above booking readings of > 30 mmHg systolic or > 15 mmHg diastolic.
What are the categories for hypertensive patients in pregnancy?
Patients should be categorized into: Pre-existing hypertension, Pregnancy-induced hypertension (PIH), and Pre-eclampsia.
What characterizes pre-existing hypertension in pregnancy?
A history of hypertension before pregnancy or an elevated blood pressure > 140/90 mmHg before 20 weeks gestation.
What are the characteristics of Pregnancy-induced hypertension (PIH)?
Occurs in the second half of pregnancy (after 20 weeks), no proteinuria, no oedema, and occurs in around 5-7% of pregnancies.
What should be done if a pregnant woman is on an ACE inhibitor or ARB?
These should be stopped immediately and alternative antihypertensives started (e.g. labetalol) while awaiting specialist review.
What is pre-eclampsia?
Pregnancy-induced hypertension in association with proteinuria (> 0.3g / 24 hours), may have oedema.
What is the management for hypertension in pregnancy according to the 2010 NICE guidelines?
Oral labetalol is now first-line, with oral nifedipine (if asthmatic) and hydralazine as alternatives.
After establishing that the patient is hypertensive they should be categorised into one of the following groups. List what you know about each category
