Hypertensive disease in pregnancy Flashcards
Define pre-eclampsia and eclampsia.
Pre-eclampsia is defined as high blood pressure, protein in the urine and oedema. Eclampsia is when the sustained high blood pressure results in symptoms such as seizures or coma.
Explain the aetiology/risk factors of hypertensive disorders in pregnancy.
History of preeclampsia
Chronic hypertension, or history of diabetes
First pregnancy
New paternity
Extremes of reproductive age
Race
Obesity
Multiple pregnancy
Interval between pregnancies
In vitro fertilization
Summarise the epidemiology of hypertensive disorders in pregnancy.
Usually begins after 20 weeks in pregnancy.
2-8% of pregnancies.
Recognise the presenting signs and symptoms of hypertensive disorders in pregnancy.
Proteinuria and kidney dysfunction
Severe headaches
Changes in vision
Upper abdominal pain
Nausea and vomiting
Thrombocytopaenia
Impaired liver function
Dyspnoea
Identify appropriate investigations for hypertensive disorders in pregnancy and interpret the results.
FBC, LFTs, U+Es
Urinalysis
Fetal ultrasound
CTG
Generate a management plan for hypertensive disorders in pregnancy.
Women at high risk of developing pre-eclampsia:
NICE recommends that women at high risk of pre-eclampsia should be given 75 mg aspirin from early in pregnancy (12 weeks) to delivery
Deliver the baby
If patient is seizing, give magnesium sulfate and deliver the baby.
If baby is less then 34 weeks, give steroids to help lungs develop.
Identify the possible complications of hypertensive disorders in pregnancy and its management.
Fetal growth restriction
Preterm birth
Placental abruption
HELLP syndrome: Haemolysis, elevated liver enzymes and low platelet count.
Eclampsia
Other organ damage e.g. eyes, liver
Cardiovascular disease
Summarise the prognosis for patients with hypertensive disorders in pregnancy.
Pre-eclampsia and eclampsia when treated generally have good outcomes, however remain the leading cause of maternal and perinatal death.
