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Reproduction > Hypertension In Pregnancy > Flashcards

Hypertension In Pregnancy Flashcards

1
Q

What happens to the blood volume during pregnancy?

A

Increases 30%

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2
Q

Plasma volume decreases during pregnancy, true/false?

A

False

Increases 45%

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3
Q

What happens to cardiac output during pregnancy

A

Increases 30-50%

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4
Q

By what % does stroke volume change during pregnancy?

A

Increases 25%

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5
Q

During pregnancy does peripheral vascular resistance increase or decrease?

A

Decreases 15-20%

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6
Q

What happens to the CVP during pregnancy?

A

Nothing it remains unchanged

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7
Q

Why does BP increase during pregnancy?

A

Peripheral vascular resistance decreases due to increased vasodilation

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8
Q

How is hypertension diagnosed?

A

> 140/90 mmHg on two occasions
OR
160/110 mmHg once

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9
Q

During their pregnancy, when are women most likely to develop pregnancy induced hypertension?

A

During second trimester

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10
Q

What is the risk of PIH becoming pre-eclampsia?

A

15%

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11
Q

Rate of recurring hypertension in pregnancy is common? True/False

A

True

Rate of recurrence is high

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12
Q

What three features found together lead to a diagnosis of pre-eclampsia?

A

Hypertension
Proteinuria
Oedema

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13
Q

When do the majority of pre-eclampsia patients present?

A

> 34 weeks gestation

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14
Q

What risks are associated with early pre-eclampsia?

A

Extensive villous and vascular lesions of placenta

Higher risk of maternal and foetal complications

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15
Q

Define pre-eclampsia

A

A pregnancy-specific multi-system disorder with unpredictable, variable and widespread manifestations ​

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16
Q

What three placental problems can occur in pre-eclampsia?

A

Restricted foetal growth
Placental Abruption
Intra-uterine death

17
Q

List three CNS complications of pre-eclampsia?

A

Intracranial hemorrhage
Hypertensive encephalopathy
Cerebral oedema

18
Q

What is HELLP syndrome?

A

This is a complication of pre-eclampsia consisting of

Haemolysis, Elevated Liver enzymes, Low Platelets

19
Q

List three hematological complications of pre-eclampsia?

A

Decreased plasma volume
Thrombocytopenia
Haemolysis

20
Q

Give three renal complications of pre-eclampsia?

A

Decreased eGFR
Proteinuria
Acute renal failure

21
Q

What two pulmonary complications can result from pre-eclampsia

A

Pulmonary Oedema

Pulmonary Embolism

22
Q

List five symptoms of pre-eclampsia

A 
Headaches
Visual disturbance
Nausea/Vomiting
Rapid oedema 
RUQ/Epigastric pain
23
Q

List 4 signs of pre-eclampsia (not the 3 diagnostic features)

A

Abdominal tenderness
Disorientation
Small for gestational age
Hyper-reflexia / clonus

24
Q

What investigations are carried out for pre-eclampsia?

A 
Us and Es 
Serum Urate
LFTs
FBC
Coagulation Screen
Urine PCR
CTG
Ultrasound
25
Q

When would you admit a woman with pre-eclampsia?

A

BP >170/110 or 140/90 with proteinuria
Significant symptoms or proteinuria (>300mg/24h)
Abnormal biochemistry
Signs of fetal compromise

26
Q

What medications are first line for hypertension management in pregnancy?

A

Labetolol
Methydopa
Nifedipine (less used)

27
Q

What 2 medications are second line for management of hypertension in pregnancy?

A

Hydralazine

Doxazocin

28
Q

Most women with pre-eclampsia deliver within 4 weeks of diagnosis. True/False

A

False

They deliver within two weeks

29
Q

Define Eclampsia

A

Tonic-clonic (grand mal) seizure occurring with features of pre-eclampsia

30
Q

In what age group is eclampsia most common?

A

Teenagers

31
Q

What is the only cure for pre-eclampsia?

A

Delivery of baby

32
Q

When should foetus be delivered in pre-eclampsia?

A 
If pregnancy at term
Unable to control BP
Eclampsia
Foetal Compromise 
Rapid deterioration of biochemistry/haematology
33
Q

What proportion of women will suffer eclampsia seizure without onset of hypertension or proteinuria

A

> 1/3rd

34
Q

What medication is given to manage eclampsia seizures?

A

Magnesium Sulfate IV

4g in 5 minutes loading dose

35
Q

What can be given is patient continues to seizure?

A

Diazepam

36
Q

What must you be careful of when monitoring patient pre and during labour with pre-eclampsia?

A

Fluid balance

Oedema from overload is commonest cause of maternal death

Reproduction (19 decks)

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