Preeclampsia Flashcards
(29 cards)
17 y.o 38 weeks feeling dizzy with edema and HTN \+ 24 urine protein collection 1/4 DTRs b/l platelets down next move?
induce labor since she is term and has neuro Sx
Tx with cytotec for cervical ripening
why do you get edema with pregnancy
uterus pushes on inferior vena cava
what is cytotec
misoprostel that causes release of PG
Mg Sulfate used for what in pregnancy
seizure prophylaxis
what to give in preecclampsia for high BP
hydralazine
what to Tx postpartum hemorrhage from preeclampsia
oxytocin
hemabate
why not give methergine in preclamptic patient who delivered
causes increase in BP
leading cause maternal and prenatal morbidity and mortality WW
preeclampsia
risk factors for increased risk preeclampsia
nulliparity age extremes chornic HTN black race high BMI DM FMH preeclampsia hydatidiform mole
Dx of preeclampsia
> 140 or DBP >90 on 2 occasions, after 20 weeks gestation
160 or DBP >110 confirmation in minutes
and
proteinuria >0.3 grams or protein/Cr ratio >0.3
(dipstick 1+)
what are indications of severe preeclapmsia disease
Sx CNS
hepatic abnormality
severe BP elevation
patient with HTN but no proteinuria… what other signs suggest preeclampsia
low platelets serum Cr >1.1 liver enzymes at least 2x pulmonary edema cerebral of visual Sx
mild preeclampsia
BP on 2 occsasions was elevated
or had proteinuria
no end organ damage
early onset preeclampsia
<34 weeks
late onset preeclampsia
> 34 weeks
indications for delivery in preeclampsia
nonreassuring fetal heart status ruptured membrane uncontrollable BP oligohydramnios severe growth restriciton oliguria pulm edema shortness of breath or chest pain with O2<94% on RA persistent HA RUQ tenderness (liver) development of HELLP
what should Cr levels do in pregnancy
go down
maternal complications preeclampsia
placental abruption acute renal failure cerebral hemorrhage hepatic failure or rupture pulm edema DIC progression to eclampsia
begining signs of HELLP
HTN and preeclampsia
what anti HTN do you give to severe preeclampsia
labetolol– only if no CHF< asthma, brady
hydralazine
nifedipine
what does nifedipine do in pregnancy
block contractions
when do give corticosteroids in preeclamptic patient
when <34 weeks
when is delivery indicated in preeclampsia
if severe >34 weeks want 37 (best)
prevention preeclampsia
daily low dose aspirin after 1st trimester
weight loss
increased exercise
