Flashcards in Hypertensive disorders Deck (58)
What is the definition of hypertension in pregnancy?
2 x readings pf 140/90 at least 4 hours apart
1 diastolic reading of 110
What are the 3 types of hypertension?
What is mild hypertension?
What is moderate hypertension?
What is severe hypertension? (emergency)
MAP of 125+
When does BP lower?
What is MAP?
mean arterial pressure - average or mean value for arterial pressure represents pressure driving the blood through the arteries
How do you calculate map?
diastolic pressure+ 1/3 (systolic pressure - diastolic pressure)
What is chronic hypertension?
hypertension that predates a pregnancy or appears prior to 20/40 - may be superimposed or secondary to another medical condition
What is gestational hypertension?
New hypertension presenting after 20 weeks without significant proteinurea
What is pre-eclampsia?
Hypertension new to pregnancy manifesting after 20 weeks associated with new onset of proteinurea
What is severe pre-eclampsia?
pre-eclampsia with severe hypertension (160+/110+)
What is eclampsia?
convulsive condition associated with pre-eclampsia
When does gestational hypertension resolve?
usually 6 weeks postnatally
What is pre-eclampsia caused by?
Widespread endothelial cell damage secondary to ischaemic placenta
What risks are there for later life if you have pre-eclampsia?
Hypertension and cardiovascular disease
Lower/other risk factors for pre-eclampsia
-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
What can women be prescribed at booking if higher risk?
75mg aspiring from 12 weeks till birth
what does aspirin do?
changes how the placenta imbeds
What are the 5 high risk factors?
-prev hypertensive disorder in pregnancy
-chronic kidney disease
-type 1 or 2 diabetes
What are the moderate risk factors?
-pregnancy interval of 10+ years
-BMI or 35+
-family hx of pre-eclampsia
-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
Signs of severe pre-eclampsia
-hypertension >160/110 with proteinuria
-thrombocytopenia - reduced platelets (<100)
-creatinine >100 mmol/l
What are the 8 maternal complications of pre-eclampsia?
- intracranial haemorrhage
- placental abruption
- HELLP syndrome
- Disemminated intravascular coagulation
- Pulmonary oedema
- Acute respiratory distress syndrome
What is the leading cause of death from severe pre-eclampsia in the UK?
What is HELLP syndrome?
EL- elevated liver enzymes
LP- low platelets
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.
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
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.