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19 Cards in this Set
- Front
- Back
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1. HELLP syndrome?
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a. HELLP syndrome is a subcategory of preeclampsia in which the pt presents w/haemolysis, elevated liver enzymes, and low platelets.
b. Results in poor maternal and fetal outcomes. c. Characterized by rapidly deteriorating liver function and thrombocytopenia |
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2. HELLP syndrome triad?
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a. Haemoloysis
b. Elevated Liver enzymes c. Low platelets |
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3. Symptoms of HELLP syndrome?
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a. Liver capsule distension produces epigastric pain, often w/progressive N/V.
b. Can lead to hepatic rupture. |
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4. Preeclampsia triad?
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1. Oedema
2. HTN 3. Proteinuria. b. Classic presentation is a nulliparous woman in her third triad. |
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5. Pathophys of Preeclampsia?
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a. Involves a generalized arteriolar constriction (vasospasm) and intravascular depletion secondary to a generalized transudative oedema that can produce sx related to ischaemia, necrosis, and haemorrhage, of organs.
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6. Diagnosis of Gestational Hypertension?
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a. BP > 140/90.
b. If pt’s 24-h urinary protein is <300 then preeclampsia can be ruled out. |
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7. Mild Preeclampsia?
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a. BP >140/90 on 2 occasions at least 6 hours apart.
b. Proteinuria >300 mg/24 hr c. Nondependent oedema (face and/or hands) |
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8. Severe Preeclampsia?
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a. BP >160/110 on 2 occasions.
b. Proteinuria >5g/24 hours |
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9. Acute Fatty Liver of Pregnancy (AFLP)?
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a. >50 also have HTN and proteinuria.
b. Presents in approx 1:10,000 pregnancies and has a high mortality rate. |
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10. How can you distinguish AFLP from HELLP syndrome?
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a. Look for labs associated w/liver failure such as elevated ammonia, blood glucose <50, and markedly reduced fibrinogen and ATIII.
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11. Tx of Mild preeclampsia?
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a. Induction of labour is tx of choice if it can be done.
b. Betamethasone is given to enhance fetal lung maturity c. Pts are often started on magnesium sulfate for seizure prophylaxis during labour and delivery and should be continued for 12-24 hours after delivery. |
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12. Tx of severe preeclampsia?
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a. First stabilize with mag sulfate and hydralazine (direct arteriolar dilator) or labetalol (beta and alpha blockage).
b. Once stabilized, if GA is between 24-32 wks, expectant management to gain tx w/betamethasone and further fetal maturity is often used. |
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13. Eclampsia?
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a. Eclampsia is the occurrence of grand mal seizures in the preeclamptic pt not attributed to other causes.
b. Note: eclampsia may occur w/o proteinuria. |
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14. Complications of Eclampsia?
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a. Cerebral haemorrhage
b. Aspiration pneumonia c. Hypoxic encephalopathy d. Thromboembolism |
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15. Why is magnesium sulfate (MgSO4) used?
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a. To decrease hyperreflexia and prevent further seizures by raising the seizure threshold.
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16. What do you give for magnesium sulfate overdose?
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a. Calcium chloride or calcium gluconate.
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17. Definition of chronic HTN in pregnancy?
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a. Defined as HTN present before conception, before 20 weeks’ gestation, or persisting more than 6 weeks postpartum.
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18. 2 most common medications for HTN in pregnancy?
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a. Labetalol (β and α blocker)
b. Nifedipine (Peripheral Ca channel blocker). |
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19. 3 Risk factors for Preeclampsia?
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1. Nulliparity
2. Preexisting HTN 3. Multiple Gestation. |
