Preeclampsia

Question 1

What is preeclampsia?

Answer 1

Hypertension in pregnancy (high blood pressure)

Question 2

Name 4 theories for causes of preeclampsia

Answer 2

• Genetic susceptibility
• Placental hypo-effusion + ischaemia
• Oxidative stress
• Endothelial cell injury

Question 3

Give 3 symptoms of preeclampsia

Answer 3

• High BP
• Proteinuria
• Headaches

Question 4

What is hypertension?

Answer 4

BP that exceeds 140/90 mmHg, measured on 2 occasions at least 4 hours apart in a previously normotensive woman

Question 5

What is proteinurea?

Answer 5

• Excess proteins in urine (>300mg in 24hr urine collection)
• Renal arteriolar vasoconstriction increases glomerular pressure causing glomerular damage
• Allows proteins to leak into urine

Question 6

How can pre-eclampsia be possibly diagnosed?

Answer 6

Uterine artery colour doppler ultrasonography

Question 7

Describe the pathophysiology of preeclampsia

Answer 7

• Abnormal placentation
• Results in inappropriate spiral artery remodelling
• Resultant tissue hypoxia causes endothelial damage leading to hypertensive pathology

Question 8

Give a maternal complication of preeclampsia

Answer 8

Eclampsia (seizures)

Question 9

What is the tonic phase of preeclampsia?

Answer 9

• Sudden tensing of skeletal muscles with stiff + extended limbs
• Brief vocalisations
• Usually lasts a few seconds
• Rapid loss of consciousness

Question 10

What is the clonic phase of preeclampsia?

Answer 10

• Convulsions
• Exaggerated limb twitches/violent shaking of stiffened extremities
• Eyes roll back/close
• Strong jaw contractions

Question 11

What is a complication of preeclampsia?

Answer 11

• Impaired hepatic function
• Indicated by abnormally elevated blood concentrations of liver enzymes (to double normal conc)
• Hepatic and/or renal failure

Question 12

What is thrombocytopaenia?

Answer 12

• Disseminated intravascular coagulation (DIS)
• Occurs when activation of clotting cascade results in widespread thrombosis (clotting), which leads to depletion of platelets.

Question 13

What does HELPP syndrome stand for?

Answer 13

• Haemolysis (ruptured blood vessels)
• Elevated liver function enzymes
• Low platelets

Question 14

Give 2 foetal consequences from reduced placental blood flow

Answer 14

• Intrauterine growth restriction (IUGR) + small for gestational age (SGA) babies
• Brain damage in severe cases

Question 15

When does preeclampsia normally resolve by?

Answer 15

6th week postpartum

Question 16

Management of preeclampsia?

Answer 16

• Refrain from alcohol + tobacco
• Anti-hypertensives prescribed when required but may reduce placental blood flow thus affecting foetal development
• Delivery is curative