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ENRP > Hypertensive Disorders in Pregnancy > Flashcards

Hypertensive Disorders in Pregnancy Flashcards

1
Q

Normal BP

A

< 120/80

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2
Q

Elevated BP

A

120-129 / < 80

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3
Q

Stage 1 HTN

A

130-139 / 80-89

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4
Q

Stage 2 HTN

A

> 140/90

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5
Q

What defines a Hypertensive Crisis?

A

Systolic > 180 and/or Diastolic > 120

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6
Q

Chronic HTN

A

HTN present before pregnancy OR
HTN that presents in the 1st half of the pregnancy OR
HTN that persists 12 weeks after delivery

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7
Q

Superimposed Preeclampsia/Eclampsia

A

Transposed onto Chronic HTN

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8
Q

What defines Mild Chronic HTN and what is the treatment?

A

BP < 160 / 110

–> Aspirin daily or start an Antihypertensive

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9
Q

What defines Severe Chronic HTN and what is the treamtent?

A

BP > 160 / 110

–> Start Antihypertensive Therapy

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10
Q

What are 3 options of medications that can be used for Severe Chronic HTN (BP > 160/110)?

A

Methyldopa
Labetalol
Nifedipine

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11
Q

With the treatment of Severe Chronic HTN (>160/110), what medications should you avoid?

A

ACEi

Angiotensin Receptor Blockers

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12
Q

ACEi and ARBs can cause fetal malformations. What are 3 examples of what can occur?

A

Renal dysgenesis
Calvarial hypoplasia
Restricted growth

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13
Q

What is Gestational HTN?

A

HTN withOUT features of Preeclampsia

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14
Q

HTN without features of preeclampsia?

A

Gestational HTN

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15
Q

When does Gestational HTN occur and resolve?

A
  • After 20 weeks gestation
  • Within 72 hours of delivery
  • Resolves within 12 weeks of delivery
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16
Q

What causes Preeclampsia?

A

Unknown

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17
Q

What is Preeclampsia?

A

HTN and Proteinuria

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18
Q

What are the risk factors for Preeclampsia?

A
  • Age < 20 or > 40, black race, assisted reproductive technology
  • No prior pregnancies or > 7 years since last pregnancy
  • Multifetal gestation
  • Obesity, diabetes, renal disease
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19
Q

What are the risk factors for Preeclampsia?

A
  • Age < 20 or > 40, black race, assisted reproductive technology
  • No pregnancies or > 7 years since last pregnancy
  • Multifetal gestation
  • Obesity, diabetes, renal disease
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20
Q

List some possible symptoms with Preeclampsia

A

Headache
Blurred vision/Scotoma (blind spot)
Abdominal pain

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21
Q

What causes the headache with Preeclampsia?

A

Cerebral edema and possible vascular issues

22
Q

When there are changes in vasculature pressure with Preeclampsia, what can that cause?

A

Pulmonary edema

Edema

23
Q

What causes the vision changes with Preeclampsia?

A

Retinal vasospasm or edema

24
Q

What causes the proteinuria with Preeclampsia?

A

Enlarged glomerular endothelial cells and narrowed capillary lumen

25
Q

What can cause the RUQ pain with Preeclampsia?

A

Liver hemorrhage, thrombi, rupture

26
Q

Preeclampsia is further categorized into what 2 categories?

A
  1. Preeclampsia without severe features

2. Preeclampsia with severe features

27
Q

What BP defines Preeclampsia without severe features?

A

> 140 / 90 BUT LESS THAN 160 / 110

28
Q

What BP defines Preeclampsia without severe features?

A

> 140 / 90 BUT LESS THAN 160 / 110

29
Q

How can the proteinuria be diagnosed with Preeclampsia without severe features?

A
  • Urine protein > 300 mg in a day
  • Urine protein:creatinine ratio of 0.3
  • Urine dipstick reading of 2+
30
Q

How can the proteinuria be diagnosed with Preeclampsia without severe features?

A
  • Urine protein > 300 mg in a day
  • Urine protein:creatinine ratio of 0.3
  • Urine dipstick of 2+
31
Q

Symptoms of Preeclampsia without severe features?

A

NONE

32
Q

What are the treatments for preeclampsia without severe features if less than 37 weeks gestation and after 37 weeks gestation?

A

< 37 weeks = observe with fetal tests

> 37 weeks = Induction

33
Q

What BP defines Preeclampsia with severe features?

A

> 160 systolic or > 110 diastolic

– on 2 occasions 4 hours apart

34
Q

What BP defines Preeclampsia with severe features?

A

> 160 systolic or > 110 diastolic

– 2 occasions 4 hours apart

35
Q

What urine change will be present with Preeclampsia with severe features?

A

Oliguria (< 500 ml in a day)

36
Q

Preeclampsia with severe features involves symptoms. What are 4?

A

Headache that does not respond to meds
Vision changes
Pulmonary edema
Abdominal pain

37
Q

What will the liver enzymes and platelets be with Preeclampsia with severe features?

A

LOW platelets

Liver enzymes 2X the ULN

38
Q

What will be found on exam with Preeclampsia with severe features?

A

Brisk reflexes

Clonus

39
Q

What will be decreased and increased with labs with Preeclampsia with severe features?

A
  • LOW platelets

- HIGH liver enzymes, LDH, Hematocrit, uric acid

40
Q

A patient with Preeclampsia with severe features should be hospitalized. What 3 antihypertensive meds can be given?

A

Labetalol
Nifedipine
Hydralazine

41
Q

What 3 antihypertensive meds can be given for Preeclampsia with severe features?

A

Labetalol
Nifedipine
Hydralazine

42
Q

If the patient is less than 37 weeks and has preeclampsia with severe features, what should be given?

A

Corticosteroids

43
Q

What should be given for seizure prophylaxis with Preeclampsia with severe features?

A

Magnesium Sulfate

44
Q

What is Magnesium sulfate given for?

A

Seizure prophylaxis with Preeclampsia with severe features

45
Q

Eclampsia

A

New onset tonic clonic seizure

46
Q

What are the treatments for Eclampsia?

A

Protect airway
Magnesium Sulfate
Lorazepam if persistent

47
Q

What can be given for the prevention of Preeclampsia?

A

Low dose aspirin

48
Q

HELLP Syndrome

A

Hemolysis
Elevated Liver enzymes
LOW Platelets

49
Q

Treatment for HELLP Syndrome?

A

Immediate delivery

50
Q

What 3 medications can be given for Preeclampsia with severe features?

A

Labetalol
Nifedipine
Hydralazine

ENRP (45 decks)

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