Hypertensive Disorders of Pregnancy Flashcards
What are the types of HTN associated with pregnancy?
- chronic HTN
- gestational HTn
- preeclampsia
- eclampsia
What is chronic HTN related to pregnancy defined as?
BP of 140/90 or more on two occasions BEFORE 20 weeks gestation or persisting beyond 12 weeks postpartum
T or F. Tx of mild to moderate HTN neither benefits the fetus nor prevents pereclampsia
T. And excessive lowering of the BP may result in dereased placental perfusion and adverse outcomes
Only when a pts BP reaches _____ in pregnancy, shoudl pharm therapy be used
greater than 150 to 180/100 to 110 mm Hg
What drugs are commonly used to treat chronic HTN in pregnancy?
ethyldopa, labetalol, and nifedipine
NOTE: ACEIs and ARBs are associated with renal dysfunction in the neonate and are never used (neither are thiazides or atenolol)
What is gestational HTN?
the development of HTN without proteinuria after 20 weeks of gestation
____% of women with gestational HTN between 24-35 weeks of gestation develop preeclampsia
50
What is preeclampsia?
the development of HTN and proteinuria after 20 weeks gestation
What are the risk factors for developing preeclampsia?
APS syndrome
chronic HTN, DM, or renal disease
elevated BMI
over 40 yo
multiple gestation
T or F. Prevention of preeclampsia through routine supplementation with calcium, magnesium omega-3 fatty acids or antioxidants is ineffective
T. Although calcium might help in high risk pts
What IS effective in decreased the risk of formation of preeclampsia?
low-dose aspirin
How is preeclampsia diagnosed?
BP of 140/90 on two plus occasions more than six hrs apart and
300 mg in a 24-hr urine specimen (urine dipsticks arent effective)
What are some signs of severe preeclampsia?
invovlement of the kidneys, brain, liver or CV system as:
- severe HA, visual disturbances, hyperreflexia
- increased peripheral vascular resistance and pulmonary edema
- oliguria and acute renal failure
- elevated LFTs and RUQ pain
What is HELLP syndrome?
A variant of severe preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelet count, occuring in up to 20% of women with severe preeclampsia
This can occur preterm (mostly), at birth, or postpartum
How is magnesium sulfate used in pregnancy related HTN?
to prevent seizures in women with preeclampsia, as well as reducing the risk of placental abruption
