Hypertensive Disorders in Pregnancy (Wootton)

Question 1

__1__ Hypertension presents before or recognized during first half of pregnancy.

__2__ Hypertension is recognized after 20 weeks gestation.

__3__ occurs after 20 weeks gestation and coexists with proteinuria.

__4__ is new onset seizure activity associated with preeclampsia.

__5__ occurs in women who have been diagnosed with chronic high blood pressure before pregnancy, but then develop worsening high blood pressure and protein in the urine.

Answer 1

1) Chronic
2) Gestational
3) Preeclampsia
4) Eclampsia
5) Chronic hypertension with superimposed preeclampsia

Question 2

Gestational HTN occurs without any features of __1__.

It occurs after __2__ weeks gestation.

It also can occur within 48-72 hours after __3__.

It resolves by __4__ weeks postpartum.

Answer 2

1) Preeclampsia
2) 20 weeks
3) Delivery
4) 12 weeks

Question 3

__1__ Preeclampsia is characterized as BP > 140/90 but less than 160/110 at least 4 hours apart.

The proteinuria is __2__ mg/24 hour or a single specimen urine protein:creatinine ratio of __3__ mg/dL or a urine dipstick reading of __4__.

Answer 3

1) Mild
2) > 300 mg/24 hour
3) 0.3 mg/dL
4) 2+

Question 4

__1__ Preeclampsia is characterized as BP systolic >160 or diastolic >110 (2 occasions 4 hours apart).

Urine production is described as __2__.

__3__ enzymes are twice the upper limits of normal.

Answer 4

1) Severe
2) Oliguria (less than 500 ml in 24 hours)
3) Liver enzymes

Question 5

Between ____ weeks gestation in a patient with mild preeclampsia you should begin induction at time of diagnosis at this gestational age.

Answer 5

37-40 weeks

If favorable cervix - induction

If unfavorable cervix - use a cervical ripening agent to begin induction

Question 6

In the management of blood pressure with antihypertensives what should be given for severe preeclampsia?

Answer 6

1) Labetalol
2) Nifedipine
3) Hydralazine

Question 7

__1__ should be administered for seizure prophylaxis in preeclampsia patients.

4 gm bolus is given as the __2__ dose.

2 gm/hr is given as the __3__ dose.

The therapeutic value is between __4__ to __4__ mg/dL.

Answer 7

1) Magnesium sulfate
2) Loading
3) Maintenance
4) 5-9 mg/dL

Question 8

Eclampsia is defined as new onset __1__ seizures.

__2__ is the first line treatment.

__3__ is indicated if it is persistent.

Answer 8

1) Tonic clonic
2) Magnesium sulfate
3) Lorazepam

Question 9

What should be done in the management of mild preeclampsia at less than 37 weeks gestation

Answer 9

Monitoring

Once (BPP) or twice (NST) weekly antepartum testing
Fetal ultrasound every 3-4 weeks
Office visits and lab eval
possibly hospitalization