Preeclampsia And Hepatic Rupture Flashcards Preview

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Definitions;
1. Chronic hypertension
2. Gestational hypertension
3. Preeclampsia
4. Eclampsia
5. Severe preeclampsia
6. Superimposed preeclampsia

1. BP >140/90 before 20 weeks gestation
2. Hypertension without proteinuria after 20 weeks gestation
3. Hypertension with proteinuria over 20 weeks gestation
4. Seizure disorder associated with preeclampsia
5. Preeclampsia with associated vasospasm that threatens maternal end organs
6. Preeclampsia in a patient with chronic hypertension

1

Old criteria for mild versus severe preeclampsia?

BP 140/90 with 300 mg proteins/24 hours

versus

BP over 160/110 with 5 g protein/24 hours

2

Urine dipstick suggestive of protein loss in mild versus severe preeclampsia?

1+ or 2+ versus 3+ or 4+

3

Underlying pathophysiology of preeclampsia? Cure?

Vasospasm and "leaky vessels" which cause local hypoxemia. Hypoxemia leads to hemolysis, necrosis, and end organ damage

End of pregnancy (Usually delivery)

4

Complications of preeclampsia?

1. Placental abruption or uteroplacental insufficiency
2. Eclampsia
3. Renal failure
4. Hepatic subcapsular hematoma or hepatic rupture
5. Coagulopathies

5

Risk factors for preeclampsia?

1. Nulliparity or multigestational
2. Extremities of age
3. African-American
4. History of preeclampsia/family history
5. Hypertension
6. Chronic renal disease
7. Diabetes
8. Antiphospholipid

6

Neurologic symptoms of preeclampsia?

Headache, vision changes/Blindness, seizures, hyperreflexia,

7

Hematologic signs of preeclampsia?

Hypertension, thrombocytopenia, microangiopathic anemia, coagulopathy

8

Fetal symptoms of preeclampsia?

IUGR, oligohydramnios, decreased uterine perfusion (late decelerations)

9

Renal and pulmonary signs of preeclampsia?

Decreased GFR, proteinuria, oligoria

Pulmonary edema

10

When to deliver regardless of gestational age? Otherwise deliver at what gestational age?

Severe preeclampsia; 37 weeks

11

When does eclampsia typically sent in?

Just prior to delivery, during labor, first 24 hours postpartum

12

Tx? When to start treatment? When to stop?

Magnesium sulfate – during labor; stop 24 hours postpartum

13

Magnesium sulfate – excretion? First sign of toxic effects? Other side effects?

Renal (ensure urine output)

Absence of deep tendon reflexes

Pulmonary edema

14

Uric acid levels in preeclampsia?

Elevated

15

Most common cause of maternal death due to eclampsia?

Intracerebral hemorrhage from seizures