5 - Obs - Hypertensive Disorders in Pregnancy - Pre-eclampsia 2

Question 1

Ix

• to confirm Dx - ??? and urine ? measurements (??? or 24h collection) - ? excluded by urine ?
• monitoring mum - watch ??, what indicates impending HELLP? (2 things) - rapid incr ? suggests severe complx and ? failure.
• monitoring fetus - ? to estimate weight at ? gest, and to assess fetal ?. Umb aa ? - if abnormal > ??? - evaluates well-being

Answer 1

MSU
protein
PCR
infection
culture
BP
LFT rise + rapid fall in platelets
Cr
renal
USS
early
growth
doppler
CTG

Question 2

screening and prevention - regular ? and ? checks

• ? aa doppler sometimes used
• ??? started before ? weeks can reduce risk

Answer 2

BP
urinalysis
uterine
LD Aspirin 75mg
16

Question 3

Criteria for admission in pre-eclampsia/suspected preeclampsia

• if have ?
• if proteinuria ? or more on ?; or >?g/24h on 24h collection
• if BP >?/?mmHg
• if suspected ??

Answer 3

symptoms
\+2
dipstick
0.3
160/110
fetal compromise

Question 4

Drugs in preeclampsia - antihypertensives if - BP reaches ?/? - urgently if ?/? - initial control with ? nifedipine, then ? labetalol if severe HTN.

Steroids if - ?/? at weeks to promote fetal ? maturity.

Mag sulph - for trt and prevention of ? in severe disease . ? is indicated if toxicity: ? depression and ? - test ? reflexes.

Answer 4

150/100
160/110
oral
IV
mod/severe
34
pulm
eclampsia
delivery
reps
hypotension
patellar

Question 5

MGMT - delivery -
before 34 weeks = ?? usually.
after 34w - can be induced with ?
-? analgesia helps ? BP
-? used in labour

• mild disease - by ? weeks
• mod-severe (w/o mat complx) - by ?-?weeks
• if mat complx -deliver at ? gestation

Answer 5

C/s
prostaglandins
epidural
antihypertensives

37
34-36
any

Question 6

Postnatally - watch ?, ? output, blood tests : ? ? ?

Ensure adequate ??

Answer 6

BP, urine
FBC, U+E, LFTs
follow up