Hypertensive disease

Question 1

What drug should be taken prophylactically in patients at high risk of pre-eclampsia?

Answer 1

75mg aspirin

Question 2

Which patients are at high risk of pre-eclampsia?

Answer 2

Previous pre-eclampsia
Existing HTN
Pregnancy induced HTN
CKD
autoimmune - SLE, antiphospholipid syndrome
Type 1 or 2 DM

Question 3

Management of moderate-severe pre-eclampsia in a patient who is <34 weeks gestation?

Answer 3

Specialist care - intensive surveillance - conservative management + steroids
Balance delivery risk of prematurity and risk to mother

Deliver straight away if signs of foetal distress

Question 4

what type of delivery method should be used to manage pre-eclampsia?

Answer 4

CS if <34 weeks

Induce with prostaglandins if >34 weeks (avoid maternal pushing if BP >160/110 in second stage - use oxytocin)