L4 Hypertension, pre-eclampsia and gestational diabetes

Hypertension pre 20 weeks of gestation = [blank_start]chronic hypertension[blank_end] Hypertension after 20 weeks: 1. BP above 140/90 = [blank_start]gestational hypertension[blank_end] 2. BP above 140/90, proteinuria and oedema = [blank_start]preeclampsia[blank_end] 3. Preeclampsia with seizure = [blank_start]eclampsia[blank_end]

Which of these is not a risk factor for gestational HTN?

Select the three first line anti-hypertensives for gestational HTN.

A severe feature of preeclampsia is visual disturbances.

HELLP syndrome: A variant of severe pre-eclampsia. Elements include: H[blank_start]aemolysis[blank_end], E[blank_start]levated[blank_end] L[blank_start]iver[blank_end] enzymes and Low P[blank_start]latelet[blank_end] count. In a woman with pre-eclampsia, the presence of any of the following is an indicator of HELLP: • Maternal platelet count of [blank_start]less than 100[blank_end] x 10^9/L • Elevated [blank_start]transaminases[blank_end] (twice normal concentration) • Haemolytic [blank_start]anaemia[blank_end]

Magnesium sulphate is an anticonvulsant used to prevent progression of preeclampsia to eclampsia. It does not [blank_start]stop[blank_end] seizures but reduces [blank_start]risk[blank_end] of a further seizure. Toxicity signs: • Loss of patellar [blank_start]reflexes[blank_end] • [blank_start]Respiratory[blank_end] paralysis • Heart block • Collapse of [blank_start]circulatory[blank_end] system • Death Antidote = calcium gluconate (10ml of 10% sln over 10 minutes)

Preeclampsia/eclampsia risks: In the baby - • Can decrease the supply of [blank_start]food and oxygen[blank_end] to the baby, this can result in reduced fetal growth • Preterm birth • Stillbirth, if placental [blank_start]abruption[blank_end] (separation of the placenta from the uterine wall), leads to heavy bleeding in the mother • Infant death In the Mum - • Stroke • Seizure • Pulmonary [blank_start]odema[blank_end] • Heart [blank_start]failure[blank_end] • Reversible [blank_start]blindness[blank_end] • Bleeding from the liver • Post-partum haemorrhage

The only cute for eclampsia is delivery.

• Women at high risk of developing pre-eclampsia are recommended to commence taking ________ and ______ before 16 weeks’ gestation

Risks for gestational diabetes: Close family [blank_start]history[blank_end] of type 2 diabetes, overweight, over [blank_start]30[blank_end], if previous baby had [blank_start]defect[blank_end] or was large, previous stillbirth or miscarriage Mechanism: placenta makes certain hormones that cause [blank_start]insulin resistance[blank_end]. Mother needs to make [blank_start]x3[blank_end] more insulin, sometimes can't be done. Symptoms: usually none, may be [blank_start]thirsty[blank_end] or tired, picked up during [blank_start]screening[blank_end] (antenatal blood tests include HbA1c) around [blank_start]20 - 24[blank_end] weeks Risks if untreated: needing C section, increased chance of HTN and [blank_start]UTIs[blank_end], fat baby, shoulder [blank_start]dislocation[blank_end] of baby during birth, [blank_start]hypoglycaemic[blank_end] baby after birth,

Pregnant women should aim to do at least 150 minutes of moderate intensity physical activity spread throughout the week, for example, 30 minutes most days a week.

Insulin aspart, lispro, glulisine are first line for gestational diabetes.

Choose the incorrect statement