Pre-eclampsia and eclampsia Flashcards
(28 cards)
What is pre-eclampsia?
New hypertension in pregnancy with end organ dysfunction or proteinuria
What is eclampsia?
When seizures develop as a cause of pre-eclampsia
What is gestational hypertension?
New hypertension in pregnancy after 20 weeks that is not associated with proteinuria
What is the triad seen in pre-eclampsia?
Hypertension
Proteinuria
Oedema
What is the cause of pre-eclampsia?
Pre-eclampsia is caused by poor vascular resistance in the spinal arteries and poor perfusion of the placenta
What are high risk factors for pre-eclampsia?
Pre-existing hypertension
Pre-eclampsia in a previous pregnancy
Existing autoimmune conditions
Diabetes
CKD
What are moderate risk factors for pre-eclampsia?
High BMI
Age > 40
More than 10 years since previous pregnancy
First pregnancy
Multiple pregnancy
Family history of pre-eclampsia
What may be offered as prophylaxis for pre-eclampsia?
Aspirin (from week 12)
Who should be offered prophylaxis for pre-eclampsia?
Women with one high risk factor, or multiple moderate risk factors
What are the symptoms of pre-eclampsia?
Visual disturbances
Headache
Nausea and vomiting
Epigastric pain
Oedema
Reduced urine output
Brisk reflexes
What is the diagnosis criteria for pre-eclampsia?
Hypertension (over 140 systolic or 90 diastolic)
PLUS any of:
- Proteinuria
- Evidence of end organ damage
- Placental dysfunction
What are the indicators of organ dysfunction in pre-eclampsia?
Raised liver enzymes
Thrombocytopenia
Raised creatinine
Seizures
Haemolytic anaemia
What test can be used to rule out pre-eclampsia?
Placental growth factor
- Tested for in women suspected of pre-eclampsia between 20 and 35 weeks
- Levels will be low in pre-eclampsia
What tests are used to monitor pre-eclampsia?
Blood pressure
Symptom monitoring
Urine dipstick
Ultrasound monitoring of fetus
What is the management of gestational hypertension?
Aim for BP 135/85
Admission for BP 160/110
Urine dipstick testing weekly
Bloods weekly
PlGF testing on one occasion
Serial fetal growth scans
What is the first line pharmacological management of pre-eclampsia?
Labetolol
What other anti-hypertensives can be used in the management of pre-eclampsia?
Nifedipine - second line
Methyldopa - third line
What is the first line management of pre-eclampsia after delivery?
Enalapril
What are the second and third line management options for pre-eclampsia after delivery?
Nifedipine or amlodipine
Labetolol or atenolol
What antihypertensive is given in severe pre-eclampsia or eclampsia?
IV hydralazine
What medication is given during delivery and in the 24 hours after to prevent seizures?
IV magnesium sulfate
What medication is used to manage seizures associated with eclampsia?
IV magnesium sulfate
What are the maternal complications of pre-eclampsia?
Eclampsia
HELLP syndrome
Disseminated intravascular coagulation
Organ failure
What are the foetal complications of pre-eclampsia?
Intrauterine growth restriction
Pre-term delivery
Placental abruption
Neonatal hypoxia
