Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
18 Cards in this Set
- Front
- Back
most commonly encountered problem in pregnancy
|
Hypertension
|
|
Chronic Hypertension
|
HTN diagnosed prior to pregnancy
BP >140/90 prior to preg or before 20 weeks |
|
Chronic Hypertension Dx requires at least one of the following...
|
1. Known HTN prior to preg
2. HTN prior 20 weeks gestation 3. presisting HTN > 12 weeks postpartum |
|
A preg-specific syndrome of reduced organ perfusion related to vasospasm and activation of the coagulation cascade
|
Pre-eclampsia
|
|
Pre-Eclampsa is characterized by triad of:
|
1. HTN after 20weeks in previously normotensive pt
2. Proteinuria 3. weight gain/edema |
|
Risk factors of pre-eclampsia
|
history of HTN
greater than 35 extreme maternal age (<18 or >35) obesity prior to preg hx of diabetes, lupus, renal disease carrying more than 1 fetus black primigravida |
|
Pre-Eclampsia sx
|
- rapid weight gain
• Elevated BP >140/90** • Proteinuria** • Headache of new onset.* • While mild lower extremity edema is common in normal pregnancy, rapidly increasing or nondependent edema may be a signal of developing preeclampsia. * • Epigastric pain is due to hepatic swelling and stretching of the liver capsule.* |
|
Pre-Eclampsia most occurs during what trimester?
|
3rd
|
|
Mild PreEclampsia
|
• BP > 140 Systolic, 90 Diastolic
• Proteinuria: 300mg protein or greater in a 24-hour specimen |
|
Severe PreEclampsia
|
• BP > 160 Systolic, > 110 Diastolic
• Proteinurea: >5gm in 24 hours, 3+ urine dip • Oliguria: less than 400ml in 24 hours • Pulmonary Edema • Epigastric or RUQ Pain: Usually indicates liver involvement |
|
Severe PreEclampsia Sx
|
• Retinal vasospasm is a severe manifestation of maternal disease; consider delivery*
• Visual disturbances: scintillations and scotomata. These disturbances are presumed to be due to cerebral vasospasm.** • Hyperreflexia-3+ DTR’s* • Clonus is a sign of neuromuscular irritability that usually reflects severe preeclampsia.* |
|
HELP Syndrome
|
Hemolysis,
Elevated Liver enzymes, Low Platelets |
|
Eclampsia
|
A true Obstetrical emergency.*
• Tonic-Clonic seizures in a pregnant female with no previous seizure history.* |
|
maternal indications for delivery in preeclampsia
|
• Gestational age 38 weeks
• Platelet count < 100,000 cells/mm3 • Progressive deterioration in liver and renal function • Suspected abruptio placentae • Persistent severe headaches, visual changes, nausea, epigastric pain, or vomiting |
|
fetal indications for delivery in preeclampsia
|
• Severe fetal growth restriction
• Nonreassuring fetal testing results • Oligohydramnios |
|
Treatment of HTN in severe Preeclampsia:
For SBP > 160 mm Hg and/or DBP > 105 mm Hg |
• Parenteral hydralazine is most commonly used.*
• Parenteral labetalol * is second-line drug (avoid in women with asthma and CHF.) • When treating hypertension, be very careful NOT to lower blood pressure too much (less than 140/90 |
|
chronic HTN with superimposed Preeclampsia
|
• Chronic HTN with : New-onset proteinuria after the 20th week of gestation.*
• Sudden significant increases in blood pressure (>160 systolic or >110 diastolic at rest), in a previously controlled HTN pt. • |
|
Gestational HTN
|
• HTN without proteinuria appearing after 20 weeks GA*
• HTN without proteinuria appearing within 48 to 72 hours after delivery.* • Resolves by 12 weeks’ postpartum.* |