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23 Cards in this Set
- Front
- Back
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Def'n Pre-eclampsia
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Multisystem disorder w/ widespread vasoconstriction
- radial arteries in placenta contstricted |
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Etiology
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- Genetic
- Poor placentation - Coagulation Defect - immunologic |
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Etiology cont'd and Features
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- PG Imbalance
- often only in first pregnancy - exposure to foreign tissue, e.g. paternal chromosomes? |
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Risk Factors PET
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- Family Hx of PET
- 1st pregnancy w/ current partner or overall - Previous PET (but less than someone who hasn't had it) - HTN - DM |
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Risk Factors Cont'd
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- Multiple Gestation
- Fetal hydrops - Molar Pregnancy - Extreme age mother - Race??? |
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DIAGNOSIS -- IMPORTANT!
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- BP > 140 / 90 or increase systolic by 30 or increase diastolic by 15
- Proteinuria > 3g / L, 300mg / 24hrs - Facial / hand edema (non-dependent!) |
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Degrees?
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Mild OR Severe
- Moderate does not exist |
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Symptoms by System
CNS |
- Headaches
- Blurred vision - Scotoma (spots in eyes) - Hyperreflexia - Seizures (i.e. eclampsia) - CVA |
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Symptoms: Cardiovascular
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- inc BP
- vasoconstriction - CVA |
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Hepatic
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- vasoconstriction
- inc AST / ALT - hepatitis / RUQ pain - Risk of rupture |
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Renal
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- vasoconstriction
- Dec perfusion Proteinuria and oliguria |
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Hematolologic
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Hemolytic anemia
DIC Thrombocytopenia |
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Uteroplacental
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vasoconstriction
decreased flow decreased AFV IUGR Fetal distress Abruption / death |
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SEVERE Pre-Eclampsia: Dx
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BP > 160 / 110
Proteinuria > 5g / 24hrs (3-4 + dip) Oliguria CNS: vision / hyperreflexia / clonus PE Epigastric pain / RUQ |
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How do you treat Severe PET?
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Deliver?
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Caveats of Dx
- Edema / Proteinuria / Presentation |
Hypertension may be mild / absent
Edema common in pregnancy Proteinuria a late sign Atypical presentation common |
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Atypical Presentations
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Headache
Scotoma Blurred Vision HELLP Syndrome DIC Convlusions (eclampsia) CVA Hemolysis / Thrombocytopenia |
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HELLP Syndrome
- what does is stand for? - what is it? |
Hemolysis
Elevated Liver enzymes Low Platelets - it is a variant of severe preeclampsia |
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Symptoms
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- Normal BP
- Epigastric pain (beware of heartburn!) |
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Management / Admission
for Mild P.Ecl |
- Admit
- Bed rest w/ bathroom privileges Monitor BP (> 150 / 110 = bad) Monitor CBC, LFT, coag, uric acid Salt restrict? No! H20 retention. |
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Management Mild PreEcl cont'd
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Daily NST
U/ S BPP IV / meds |
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Tx: Severe Pre-Eclampsia
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- Admit / stabilize mother
Evaluate fetus Deliver by induction or C/S |
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Medical Management Severe Pre-Eclampsia
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IV NS
Hydralazine / labetalol (for HTN) Anticonvulsants (Mg S04) - preventative Anesthesia / delivery! |
