Small Group: Maternal Diseases

Question 1

What is the definition of chronic hypertension in pregnancy?

Answer 1

SBP greater than 140 mm Hg or DBP greater than 90 mm Hg prior to the 20th week of pregnancy

Question 2

What is gestational hypertension?

Answer 2

SBP greater than 140 mm Hg or DBP greater than 90 mm Hg after the 20th week of pregnancy

Question 3

What is the definition of preeclampsia?

Answer 3

• SBP greater than 140 mm Hg or DBP greater than 90 mm Hg occurring in a previously normotensive woman

and any of the following:

• Proteinuria (300 mg in 24 hours or P:C ratio greater than 0.3); cerebral or pulmonary edema; liver dysfunction; thrombocytopenia (less than 100k)

Question 4

What is chronic hypertension with new-onset proteinuria?

Answer 4

Exactly what it sounds like: chronic hypertension with new-onset proteinuria, transaminitis, or thrombocytopenia

Question 5

What are the features of severe preeclampsia?

Answer 5

• SBP greater than 160 mm Hg or DBP greater than 110 mm Hg occurring in a previously normotensive woman on at least two occasions at least four hours apart
• Renal insufficiency (serum creatinine concentration greater than 1.1 mg/dL or a doubling of the serum creatinine concentration in the absence of other renal disease)
• Impaired liver function as indicated by abnormally elevated blood concentrations of liver enzymes (to twice normal concentration), severe persistent right upper quadrant or epigastric pain unresponsive to medication and not accounted for by alternative diagnoses, or both
• Pulmonary edema
• New‐onset cerebral or visual disturbances

Question 6

The normal range for the one-hour GTT is ___________.

Answer 6

less than 135 mg/dL

Question 7

High A1cs correlate with ____________.

Answer 7

greatly increased rate of malformations (spinal, pulmonary valve, etc.)

Question 8

How does GD affect amniotic volume and gestational size?

Answer 8

LGA and polyhydramnios

Question 9

When should HTN be treated in pregnant women?

Answer 9

SBP greater than 160 mm Hg or DBP greater than 110 mm Hg occurring in a previously normotensive woman on at least two occasions at least four hours apart

Because pregnancy is a short period in a woman’s life, higher blood pressures are acceptable.

Question 10

Normally, one hour after a meal a pregnant woman’s blood glucose should be _____________.

Answer 10

less than 140 mg/dL