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Flashcards in Hypertensive disorders Deck (58)
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1

What is the definition of hypertension in pregnancy?

2 x readings pf 140/90 at least 4 hours apart
or
1 diastolic reading of 110

2

What are the 3 types of hypertension?

mild
moderate
severe

3

What is mild hypertension?

140-149/
90-99

4

What is moderate hypertension?

150-159/
100-109

5

What is severe hypertension? (emergency)

160+/110+
MAP of 125+

6

When does BP lower?

second trimester

7

What is MAP?

mean arterial pressure - average or mean value for arterial pressure represents pressure driving the blood through the arteries

8

How do you calculate map?

diastolic pressure+ 1/3 (systolic pressure - diastolic pressure)

9

What is chronic hypertension?

hypertension that predates a pregnancy or appears prior to 20/40 - may be superimposed or secondary to another medical condition

10

What is gestational hypertension?

New hypertension presenting after 20 weeks without significant proteinurea

11

What is pre-eclampsia?

Hypertension new to pregnancy manifesting after 20 weeks associated with new onset of proteinurea

12

What is severe pre-eclampsia?

pre-eclampsia with severe hypertension (160+/110+)

13

What is eclampsia?

convulsive condition associated with pre-eclampsia

14

When does gestational hypertension resolve?

usually 6 weeks postnatally

15

What is pre-eclampsia caused by?

Widespread endothelial cell damage secondary to ischaemic placenta

16

What risks are there for later life if you have pre-eclampsia?

Hypertension and cardiovascular disease

17

Lower/other risk factors for pre-eclampsia

-new partner
-booking bp /80+ or booking proteinurea 1+
-1+ protein on more than one
-latin american or carribean
-donor eggs - other DNA
-postpartum - headache for 1-3 days

18

What can women be prescribed at booking if higher risk?

75mg aspiring from 12 weeks till birth

19

what does aspirin do?

changes how the placenta imbeds

20

What are the 5 high risk factors?

-prev hypertensive disorder in pregnancy
-chronic kidney disease
-autoimmune disease
-type 1 or 2 diabetes
-chronic hypertension

21

What are the moderate risk factors?

-primip
-age 40+
-pregnancy interval of 10+ years
-BMI or 35+
-family hx of pre-eclampsia
-multiple pregnancy

22

Antenatatal symptoms

-new hypertension
-new or significant proteinurea >1+
-mat symptoms of headache or visual disturbances
-epigastric pain or vomiting
-rfm or small for dates
-sudden and marked oedema- face/hands/ feet

23

Signs of severe pre-eclampsia

-hypertension >160/110 with proteinuria
OR
->3+ proteinurea
OR
-thrombocytopenia - reduced platelets (<100)
-creatinine >100 mmol/l

24

What are the 8 maternal complications of pre-eclampsia?

- intracranial haemorrhage
- placental abruption
- eclampsia
- HELLP syndrome
- Disemminated intravascular coagulation
-Renal failure
- Pulmonary oedema
- Acute respiratory distress syndrome

25

What is the leading cause of death from severe pre-eclampsia in the UK?

intracranial haemorrhage

26

What is HELLP syndrome?

H- haemolysis
EL- elevated liver enzymes
LP- low platelets

27

What is Disemminated intravascular coagulation?

A condition in which blood clots form throughout the body's small blood vessels which reduce or block floor- damages organs. The increased clotting uses up platelets and clotting factors. With less of thees, serious bleeding can occur. It can cause internal and external bleeding.

28

What is renal failure?

Due to not passing urine, increased fluid in the body leaks into the tissues due to high blood pressure, leads to oedema

29

What is acute respiratory distress syndrome?

infections, injuries and other conditions cause fluid to build up in air sacs. Prevents lungs from filling with air and moving enough oxygen into the bloodstream.

30

What are fetal complications of pre-eclampsia?

-fetal growth restriction
-oligohydramnios
-hypoxia from placental insufficiency
-placental abruption
-premature delivery