Preeclampsia

Question 1

What are the differences between gestational hypertension, chronic hypertension and preeclampsia?

Answer 1

Gestational hypertension is new onset hypertension that occurs after 20 weeks gest. with no other organ involvement
Chronic hypertension is previous hypertension occurring before pregnancy
Preeclampsia is hypertension after 20 weeks with organ involvement (usually proteinuria)

Question 2

What are some risk factors for developing preeclampsia?

Answer 2

Pre-existing HTN
DM
Obesity
Nulliparity
Twins
Family history

Question 3

What is the pathophysiology behind preeclampsia?

Answer 3

Decreased trophoblast invasion
Spiral arteriole insufficiency
Placental ischemia

Question 4

What are the complications/symptoms you should ask about in a preeclampsia history?

Answer 4

Headache
Blurred vison
Hyperreflexia
Breathlessness
Epigastric pain
Fetal movements
Proteinuria
Swelling
HELLP Syndrome
Eclampsia

Question 5

What are the important investigations?

Answer 5

MSU
Dipstick
24 protein
FBC-platlets
Coags
Uric acid, protein-creatine ratio (should be less than 30 in pregnant women)
LFTs
Group and Hold

Question 6

How can we prevent preeclampsia?

Answer 6

100 mg aspirin PO from 12 weeks

Question 7

What are the treatment options for preeclampsia in a woman <37 weeks?

Answer 7

Nifidepine (best acutely)
Labetolol
Methyldopa