Hypertensive Disorders in Pregnancy Flashcards
What is the first thing to think about when treating HTN in pregnancy
Potential underlying causes
What is the course of action for mild HTN <160/110
start aspirin 81 mg
Prenatal ever 2-4 weeks
Antepartum fetal monitoring
what medications are absolutely contraindicated in treating HTN
ACE inhibitors
ARBs
What is gestational HTN
HTN without any features of preeclampsia
what are the key features of preeclampsia
HTN
Proteinuria
What are common symptoms of preeclampsia
Scotoma
Blurred Vision
Epigastric or URQ pain
Headache
in preeclampsia how is the head affected
Cerebral edema, thrombosis, micro-infarcts
in preeclampsia how is the heart affected
reduction in circulating blood volume
absence of normal intravascular volume expansion
in preeclampsia how are the lungs affected
non-cardiogenic pulmonary edema
what defines mild (preeclampsia without severe features)
BP >140/90 but <160/110
Proteinuria >300 mg/24hrs
asymptomatic
What defines severe (preeclampsia with severe features)
BP >160 sys or >110 dias 4 hrs apart Oliguria <500 ml/24hrs Elevated liver enzymes 2X normal Thrombocytopenia Pulmonary edema Symptomatic
What are exam findings in preeclampsia
brisk reflexes
clonus
edema
What are lab value findings in preeclampsia
increased
hematocrit
lactate dehydrogenase
Transaminases
Uric Acid
how do you manage preeclampsia without severe features in less than 37 weeks
once or twice weekly antepartum testing
Fetal growth US every 3-4 weeks
Office visits and laboratory evaluations
Possible hospitalization
How do you manage preeclampsia without severe features between 37-40 wks gestation
Induction at time of diagnosis
If favorable use cervix induction
if unfavorable use cervical ripening
