PRE-ECLAMPSIA Flashcards
Pre-eclampsia is characterised by……
Hypertension and Proteinuria
……………….. and ……………. are essential in the monitoring of pre-eclampsia together with the recommended investigations
BP monitoring every 4 hours
and
Daily weight of the patient
Target BP in pre-eclampsia
Not less than 140/90
Why isn’t the BP lowered below the target in pre-eclampsia
It may cause foetal distress due to reduced perfusion
Which part of pregnancy does Pre-eclampsia occur
Second half of pregnancy
Investigations done in Pre-eclampsia
FBC
RBG
LFTs
BUE and creatinine
Urinalysis and Culture
Ultrasound scan
Daily urine protein assesment
Serum uric acid
Signs of mild pre-eclampsia
BP between 140/90 to 150/109
Proteinuria of 1+/2+
Pedal edema
Signs of severe pre-eclampsia
BP of 160/110 or higher
Proteinuria of 3+/4+
Pedal or generalized edema
Treatment objectives in pre-eclampsia
To reduce BP but not less than 140/90
To prolong pregnancy as long as possible
To prevent fœtal distress
To prevent or treat any complications that might arise
To prevent eclampsia
Why is prolonging the pregnancy as long as possible a treatment objective in pre-eclampsia
To allow the fœtus to grow and mature for delivery
Non-pharmacological management of pre-eclampsia
Admit for rest if possible
Tell patient to lie on their sides
Patients with pre-eclampsia are advised to lie on their side to prevent…..
Supine hypotension
At which BP is it necessary to initiate pharmacological management of pre-eclampsia
SBP above 150 or DBP above 100 or Symptoms of imminent eclampsia
Pharmacological management of mild pre-eclampsia
Methyldopa PO 250-500mg 8-12 hourly max of 2g daily
Nifedipine retard PO 10-40mg 12 hourly
Nifedipine sustained release 30-60mg daily
Medical disorders associated with pre-eclampsia
Kidney disorders
Diabètes mellitus
Polycystic ovaries
Chronic hypertension
