preeclampsia
A multisystem disorder specific to pregnancy and puerperium, manifesting by the onset of hypertension and proteinuria after 20 weeks of gestation
what is preeclampsia?
Although no longer favored in non-pregnant patients, this centrally acting alpha-adrenergic agonist is considered the "gold standard" during pregnancy due to its long safety record
what is alpha methyl dopa?
The classification given to hypertension that has been documented before pregnancy or persists beyond 12 weeks after delivery
What is chronic hypertension?
The development of seizures that cannot be attributed to other causes and/or unexplained coma during pregnancy or puerperium in a woman with pre-eclampsia
what is eclampsia?
A systolic blood pressure of 160 mmHg or more, or a diastolic blood pressure of 110 mmHg or more (confirmed within minutes), is one of the diagnostic criteria for this
what is severe preeclapsia?
Thrombocytopaenia: Platelet count <100,000 109/l – Renal insuf!ciency: Serum creatinine concentrations >1.1 mg/dL or a doubling of serum creatinine – Impaired liver function: Elevated liver transaminases to twice the normal – Pulmonary edema – New-onset headache unresponsive to medication and not accounted for by alternative diagnoses or visual
what are the criteria to be consider in the absence of proteinuria to diagnose preeclampsia?
This class of antihypertensive drugs, commonly used outside of pregnancy, must be stopped and changed to safer drugs prior to or during pregnancy
What are ACE inhibitors?
The woman with secondary hypertension, severe hypertension or complicated with target organ damage (left ven-tricular dysfunction, retinopathy, dyslipidaemia, microvascular disease or stroke), maternal age above 40 years or a history of previous perinatal loss
what is high risk chronic hypertension?
The drug of choice for both the prevention and treatment of eclampsia, found to be superior to other agents in major studies?
What is magnesium sulphate (MgSO4) role in eclampsia?
Due to the risk of hypertension crisis resulting from intense vasoconstriction, this uterotonic drug should not be administered during the third stage of labor in women with pre-eclampsia
what is the role of ergotalkaloids in eclampsia?
maternal risk factors, MAP, sPLF, UTPI
what is universal screening for preeclampsia in FIGO?
labetalol and methyldopa
what are the two most common first-line oral drugs for treating non-severe hypertension in pregnancy
140/90
what is the stricter systolic and diastolic blood pressure goals for pregnant women with chronic hypertension with target organ damage?
Eclampsia is designated by this term when convulsions occur after delivery but within 4 weeks postpartum
What is late postpartum eclampsia?
The two opposing mechanisms implicated in the pathogenesis of eclampsia in the brain, involving either intense narrowing or over-dilatation of cerebral vessels
what is pathogenesis of eclampsia?
The only drug recommended for the prevention of pre-eclampsia in women at high risk
what is the low dose Aspirin? or what is the role of aspirin in HDP?
This rapidly acting IV drug for severe hypertension directly inhibits smooth muscle contraction but may cause initial severe headache and mimic impending eclampsia due to increased intracranial pressure.
What is hydralazine?
Although generally not recommended in pre-eclampsia due to volume depletion, this type of drug is often continued in women with chronic hypertension because it is effective and potentiates other antihypertensive agents
what is the role of diuretics- thiazide?
absence of patellar reflexes
what is the first sign of impending magnesium toxicity?
34 weeks
what is the minimum gestational age at which delivery is generally indicated for pre-eclampsia with features of severe disease, following maternal stabilization
This anti-angiogenic peptide is a variant of the receptor for placental growth factor (PlGF) and vascular endothelial growth factor (VEGF), and its elevated levels contribute to angiogenic imbalance in pre-eclampsia
What is soluble fms-like tyrosine kinase 1 (sFlt1)?
150/100mmhg
what is the treating level of blood pressure to prevent severe hypertension?
For women with low-risk chronic hypertension, antihypertensive therapy is beneficial primarily for reducing the rate of this complication
how to reduce the progression to severe hypertension in low risk CHT?
clearing airway and preventing maternal injury
what is the first step in managing eclampsia?
It is a well-recognized complication of severe pre-ec-lampsia, although at times, it can occur in the absence of hypertension and proteinuria.
what is HELLP syndrome?