Hypertension in Pregnancy Flashcards
What happens to vessels during pregnancy?
Vasodilation
Is blood pressure high or low in early pregnancy?
Low
Is blood pressure high or low in late pregnancy?
High
When is the lowest blood pressure in pregnancy?
22-24 weeks
What are the parameters/criteria for diagnosing hypertension in pregnancy?
Greater than 140/90 on 2 occasions
Diastolic greater than 110
If hypertension persists within 3 months of delivery of a baby, what is the likely diagnosis?
Pre-existing (undiagnosed) hypertension
When should pregnancy-induced hypertension resolve by?
6 weeks following delivery
What are the 3 main features of pre-eclampsia?
Hypertension
Proteinuria
Oedema
How much proteinuria meets the criteria for pre-eclampsia?
0.3 g/l or more
0.3 g or more in 24 hour period
2+ on dipstick
Describe the pathogenesis of pre-eclampsia
Abnormal placentation and failure of trophoblast invasion cause spiral arteries to stay as high resistance/low flow vessels, leading to placental endothelial damage and thrombosis
What syndrome related to liver disease are women with pre-eclampsia at risk of?
HELLP syndrome
Haemolysis, Elevated Liver enzymes, Low Platelets
List clinical features of pre-eclampsia
Headache
Visual disturbance
Epigastric/RUQ pain
Nausea/vomiting
How can pre-eclampsia be screened for/predicted?
Uterine artery doppler to assess blood flow - if poor flow (notching) then high risk
What are the 4 main drugs used for hypertension in pregnancy?
Methyldopa
Labetolol
Nifedipine
Hydralazine
When is methyldopa contraindicated in hypertension in pregnancy?
Depression
