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Gynae > Eclampsia and Pre-eclampsia > Flashcards

Eclampsia and Pre-eclampsia Flashcards

1
Q

Definition of Pre-eclampsia?

A

New onset of:
Hypertension + Proteinuria (>0. 3g)

> 20 weeks of gestation

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2
Q

Types of Pre-eclampsia?

A

Mild - 140, 90
Severe - 160, 110

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3
Q

Complications of severe Pre-eclampsia?

A

Hemorrhagic shock + Placental Abruption

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4
Q

Risk Factors of Pre-eclampsia?

A

First pregnancy
Multiple gestation
Family History
Mother >35
Chronic HT

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5
Q

Pathogenesis of pre eclampsia

A

Due to development of abnormal placenta
Uteroplacental arteries become fibrous - > narrow

Poorly perused placenta
- IUGR
- Fetal Death
- Releases inflammatory mediators - > enter mothers circulation - > vasoconstriction - > HT

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6
Q

Why does Pre-eclampsia cause Proteinuria

A

Decreased blood flow to kidney - >decreased GFR - > Proteinuria + Oliguria

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7
Q

What is HELLP syndrome?

A

Hemolysis
Elevated Liver enzymes
Low Platelets

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8
Q

Explain Oedema in Pre-eclampsia

A

Proteinuria -> hypoproteinemia - > Generalised Oedema

If cerebral Oedema - > SEIZURES (Eclampsia)

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9
Q

Clinical Features of Pre-eclampsia?

A

Headaches + Confusion
Visual Symptoms
Generalised Oedema + Pulmonary Oedema (dyspnoea)
RUQ pain
May be asymptomatic

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10
Q

Dx of Pre-eclampsia?

A

Investigate HELLP - LFTs + FBC (low platelet)
Urinalysis (Proteinuria)
Blood pressure - HT
Renal Function - decreased GFR

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11
Q

Treatment of Pre-eclampsia
Mild, Severe, Medications

A

Mild -
Preterm - monitoring + medication
Term - Delivery (vaginal)

Severe -
Delivery (even if preterm)

Medications
Acute - Labetalol (worsens IUGR) , Hydralazine (only severe cases), Nifidipine (Ca Channel blocker)
Continued - Methyldopa + MgSO4 prophylaxis. Dexamethasone for maturation of Fetal lungs

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12
Q

What is Eclampsia?

A

Seizures in a woman with Pre-eclampsia

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13
Q

Which period does Eclampsia occur in?

A

All of them
Antenatal, Intrapartum, Postpartum

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14
Q

Symptoms of Eclampsia?

A

Tonic colonic seizures
Symptoms of Pre eclampsia Before seizures

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15
Q

Complications of Eclampsia?

A

Death - due to hemorrrhagic stroke
Obstetric emergency

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16
Q

Management of Eclampsia?

A

Treatment with Magnesium Sulphate - Doc (cerebral vasodilator - > increased blood flow)
Treatment with Thiopental (barbiturates for seizures)
ABCs (maintain open airways, control BP (Labetalol)

Definitive treatment after stabilization - Delivery ( C - Section)

17
Q

What is gestation hypertension

A

MILD HTN without Proteinuria

18
Q

Complications of Gestational HT?

A

May progress on to Pre-Eclampsia

19
Q

Fisk Factors of Gestational hypertension

A

Nulliparity
<18, >40yo
Family history
Chronic HT

20
Q

Management of Gestational Hypertension

A
  1. Observational - monitoring BP and Fetal growth + looking for signs of pre eclampsia
  2. Medical - Methyldopa, Nifidipine

Gynae (15 decks)

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