Pre-Eclampsia

Question 1

What is the pathophysiology behind pre eclampsia?

Answer 1

• impaired trophoblastic invasion of maternal spiral arteries
• This causes an immune response and endothelial fragments disperse
• This causes kidney damage and increased GFR and renin (HTN) and proteinuria

Question 2

What are the cardinal symptoms of pre eclampsia?

Answer 2

Hypertension

Proteinurea

Oedema

Question 3

When does pre eclampsia lead to eclampsia?

Answer 3

When cerebral perfusion is reduced and seizures begin

Question 4

What can be given to try and prophylactically stop seizures?

Answer 4

IV magnesium sulphate

Question 5

What are some other symptoms of pre eclampsia?

Answer 5

Headaches, visual disturbances

Liver derangement

Renal insufficiency

Question 6

What is HELLP syndrome?

Answer 6

Haemolysis

Elevated liver enzymes

Low Platelets

Question 7

What are some risk factors for pre eclampsia?

Answer 7

1st pregnancy with new partner

Previous pregnancies with existing partner where you have had pre eclampsia

Old or young age

Placental stress eg twins

Pre existing renal disease

Question 8

What investigations may you do?

Answer 8

U and E - Kidney function

FBC - Platelets

LFT - Liver function

MSU/urinalysis - ?Proteinuria and to check it isnt and infection

Foetal CTG and US

Question 9

What is the prophylactic management?

Answer 9

Aspirin

Anti platelets

To stop HTN

Question 10

What anti hypertensives are used?

Answer 10

Labetalol

Nifidipine

Question 11

When do you deliver in mild/moderate pre eclampsia

Answer 11

37 weeks

Question 12

When do you try and get to to deliver is severe pre eclampsia or eclampsia?

Answer 12

34 weeks

Question 13

When can hypertension not be pre eclampsia?

Answer 13

Renal disease

Essential hypertension

Transient hypertension

Pregnancy induced hypertension (PIH)