Hypertension in Pregnancy Flashcards
What 4 drugs can be used to lower BP in pregnancy?
Lower - labetalol
New - nifedipine
Mothers - methyldopa
Hypertension - hydralazine
What are the two classifications of pre-eclampsia?
Mild
- Mild hypertension (140-149/90-99)
Moderate –> severe
- Moderate and severe hypertension with proteinuria
How is proteinuria defined in pre-eclampsia?
+2 on dipstick
OR
> 0.3g/day
What causes pre-ecclampsia?
Impaired infiltration of the spiral arteries
What does the impaired spiral artery infiltration lead to?
Reduced placental perfusion
What is imbalanced in pre-ecclampsia?
Prostaglandin
Thromboxane
What are risk factors of pre-ecclampsia?
Pregnancy
- Primiparity
- Multiple pregnancy
Previous pregnancy
- Previous pre-ecclampsia
- Long pregnancy interval
Other
- Age
- Obesity
- Diabetes
Typical presentation?
” 35 y/o primigravida woman at 30wks presents with a headache and abdominal pain. She is found to have a BP of 155/100 and dipstick reveals proteinuria of +2. “
Symptoms of pre-ecclampsia?
Headache
Abdo pain
Reduced foetal movement
CAN CAUSE SEIZURE
Tests for pre-ecclampsia?
BP
Urinalysis
Bloods
CTG
What bloods should be done in pre-ecclampsia?
Need to check for HELLP syndrome
- Platelets
- LFT’s
What is HELLP syndrome?
Haemolysis Elevated LFTs Low Platelets
What LFT is specifically raised in HELLP?
Bilirubin
What test is very good for diagnosing pre-ecclampsia?
Umbillical artery doppler ultrasound
Pharma treatment of pre-ecclampsia?
Labetalol
Nifedipine
Methyldopa
Hydralasine
