Hypertensive Disorders in Pregnancy | Cheat Sheet

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

137

Pages:

6
Author:

Mariam A. A.

Hypertensive Disorders in Pregnancy Nempfitamine – not used unless there is a crisis End organ damage General unwellness Risk of progression to stroke Seizures Upper right quadrant pain Placental hypoperfusion -> increased risk of placental abruption Oligohydramnios Fetal growth restriction 34 weeks lady with a BP on 140/110 Blood pressure is always on the right -> always a manual and while sitting with leg stretch – repeat in 5 minutes If still high after 5 minutes Vitals Urine dipstick -> Proteinuria -> one or more + Send urine -> check for protein:Cr ratio -> as accurate as a 24 hour urinary collection Do a normal abdominal palpation CTG Growth ultrasound to make sure that her perfusion is good Bloods Coagulation, LFTs, platelets, UEC , FBC, antigens (give an idea on how close she is getting to eclampsia) Labetalol First line agent Commence on lowest effective dose -> monitor Review again in less than 1 week -> see her every 2 to 3 days, blood every week and ultrasounds every forhnight (as need 10 days in between), a flows every week If 160/10 Do everything above again Add cannulas -> IV fluids Need hospitalisation Bring blood pressure slowing Fetal welfare If eclampstic seizures We do not use normal meds because of bbay Usually self limiting -> last for 90 seconds and happen every 2 minutes Give MgSO4 when not seizing to prevent further ones from happening If given -> monitor her heart rate If at 34 weeks -> elective C section DIC and HELLP cause serious things that we need to watch out The only cure is to get her as far as possible and remove the placenta (i.e. through delivery) We want to try to get them to 37 weeks May need to give 5 meds to maintain BP Need to monitor baby to ensure that it is going well. Less than 32 weeks -> early onset of pre-eclampsia Risk factors Changes partner -> if his previous partner had it, then there is an increased risk Hence some evidence that may pertain mail Gap of 10 years Body things they are beginner, but they are also older Age Obesity Multiple gestational Nulliparity Autoimmune diseases e.g. SLE, antiphospholipid syndrome Renal disease ROM Extremes of maternal age Prophylaxis Aspirin (low dose) -> vasodilate (open vessels) and improves spiral arteries and causes them to go deeper From earlier than 16 to 36 weeks Standard dose 150 mg old ladies-> if has a high BMI may be 300 mg Calcium also does the same as above Exercise and diet (so that does not put on a lot of blood) So that we know it is more a fluid weight rather than body weight gain Weight cut offs Low BMI -> 16 kg Moderate 10 to 12 kg High BMI -> 5 to 7 kg Oligohydramnios One of first signs that baby is not managing well AFI -> 8 to 25 range