pre eclampsia Flashcards

1
Q

what is it

A

pregnancy induced hypertension with proteinuria and oedema

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2
Q

when does it usually develop

A

after 20 weeks, resolves within 10 days of delivery

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3
Q

risk factors pre eclampsia severe risk

A

chronic hypertension, hypertension in previous pregnancy, CKD, DM, autoimmune disease

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4
Q

risk factors moderate risk

A

1st pregnancy >40 yrs; pregnancy interval >10y, BMI high, FH eclampsia, multiple pregnancy

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5
Q

what should you take if 1 high risk or 2 moderate risk factors

A

aspirin 75mg from 12th week pregnancy

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6
Q

effects of pre eclampsia

A

plasma vol decr, incr peripheral resistance, DIC, oedema may be sudden, proteinuria late sign

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7
Q

preventing eclampsia

A

bp checks and urinalysis; MgSO4, uterine artery Doppler

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8
Q

symptomatic pre eclampsia

A

headache, chest or epigastric pain, vomiting, increased pulse, visual disturbance- central scomata, shaking, hyperreflexia with clonus, irritability

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9
Q

what is the BP

A

> 140/90

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10
Q

management- when to admit to hospital

A

if the bp rises by >30/20 over booking bp, if bp >160/100 or if bp >140/90 + proteinuria or growth restriction- admit to hospital

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11
Q

management in hospital

A

bp every 2-4 hours, weigh daily, test all urine for protein, monitor fluids, check U&E, LFTs, platelets. CTG

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12
Q

treatment hypertension

A

labetalol - 200 mg total. alternative hydralazine

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13
Q

fetal risk factors for pre eclampsia

A

hydatiform mole, multiple pregnancy, placental hydrops

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14
Q

diagnosis pre eclampsia

A

hypterntension after 20 weeks with one or more of: proteinuria, renal insufficiency, liver disease, neuro problems, haem- DIC, thrombocytopenia, uteroplacental dysfunction

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15
Q

what symptoms can you get from liver disease due to pre eclampsia

A

epigastric or RUQ pain

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16
Q

what syndrome can you get

A

HELLP

17
Q

what does HELLP stand for

A

haemolysis, elevated liver enzymes, low platelet count

18
Q

effects of pre eclampsia on the baby

A

asphyxia, abruption, small babies

19
Q

what is the only cure

A

delivery

20
Q

what is severe pre eclampsia

A

bp >160/100 with proteinuria or >140/90 with proteinuria and one of other symptoms

21
Q

treatment severe pre eclampsia

A

MgSO4 4g IV over 15 mins in 100ml 0.9% saline; catheterise; monitor FHR; delivery

22
Q

when should baby be kept inside up until

A

35 weeks if before 34 weeks - monitor well being

23
Q

if diagnosed after 35 weeks what is the management

A

labour induced or C section

24
Q

should pre eclampsia be allowed to exceed term

A

no as death increases

25
Q

does pre eclampsia recur in next pregnancy

A

5% of next pregnancies

26
Q

features eclampsia

A

convulsions and coma. preceded by disorientation- restless, twitchy, tonic clonic

27
Q

treatment eclampsia

A

MgSO4 4mg over 5 mins maintain for 24 hour (1g/h); second seizure give 2mg

28
Q

when should you stop MgSO4 in eclampsia

A

if RR

29
Q

what can you give if toxic from MgSO4

A

calcium gluconate