Hypertension during Pregnancy Flashcards
Hypertension during pregnancy important information
*HTN in pregnancy: not physiological ever
Classification according to severity:
○Mild to moderate : Systolic BP>140-180mmHg, Diastolic BP>90-110MMHg or both.
○Severe : Systolic BP>180mmHg, diastolic >100mmHg or both
-Treatment:
○ Alpha-methyldopa, hydralazine, propranolol, labetalol, nifedipine, thiazide diuretics.
■ Atenolol and bisoprolol are contraindicated, but other beta blockers are allowed.
○ Diuretics that can be given if neccessary
■ Use mannitol in case of BOTH brain and lung edema
Eclampsia-Preeclampsia
-Pre-eclampsia- Generalized maternal vasospasm.
Eclampsia is a severe form of preeclampsia characterized by the onset of seizures or coma in a woman with preeclampsia.
Causes: Eclampsia is believed to be caused by the same underlying factors as preeclampsia.
Symptoms: Eclampsia is characterized by seizures, often preceded by severe headaches, visual disturbances, and abdominal pain.
Diagnosis: Eclampsia is diagnosed when a woman with preeclampsia experiences seizures and according to BP measurement:
○Mild= BP>140/90+proteinuria >300mg/day after 20th week gestational.
○Severe= BP >160/110 + Proteinuria >5g/day after 20th week gestational.
Treatment: Treatment involves managing seizures, controlling blood pressure, and preventing complications. Medications such as magnesium sulfate may be used to prevent and treat seizures.
Anti-HTN drugs like hydralazine or labetalol. !! Never ACEis!!!
Complications: Eclampsia can have serious complications for both the mother and baby, including brain damage, stroke, organ damage, and fetal distress.
HELLP
asked that for the final exam.
○ Hemolysis Elevated Liver enzymes Low Platelet counts
○ Manifestation of preeclampsia. RUQ pain due to liver stretch, N/V, malaise
○ Correct coagulopathy, suggest delivery based on fetal status, lab
abnormalities, etc
○ Anti-HTN drugs like hydralazine or labetalol, mag sulfate, steroids if necc.
Normalize labs then induce. Delivery is tx.
● Mississippi classification for HELLP: severity of HELLP based on platelet counts,
graded from 150,000 (Class 3) 100,000 (Class 2) 50,000 (Class 1). No idea why they
asked that for the final exam.
