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Ecclampsia (Transient HTN
preg or not (Chronic HTN (gestational HTN…
Ecclampsia
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Chronic HTN
≥140/≥80
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:warning: avoid teratogens :spider:
- Alpha methyl dopa (right answer)
- Labetalol
- Hydralazine
close monitoring
- more frequent UA & US (IUGR dx)
- more frequent assessments (see a specialist)
gestational HTN
mild Preeclampsia
- PEC (w/o severe features)
more of a spectrum than discrete Dx
severe Preeclampsia
- SPEC (w/ severe features)
≥160/≥110
severe: >5g/ dL
:red_flag:
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Ecclampsia
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Hemolysis
Elevated ↑ Liver Enzymes
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Severe Features?
- Stretch of Gleason's capsule
Decreased Platelets
Increased Liver Enzymes
RUQ Abn Px
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≥140/≥80
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Essentially the same as cHTN
- but it can progress to preeclampsia
:warning: avoid teratogens :spider:
- Alpha methyl dopa (right answer)
- Labetalol
- Hydralazine
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- SVR falls in pregnancy. :pregnant_woman::skin-tone-2: BP should be lower than baseline
- Elevated BP is pathologic, use it as a marker for eclampsia spectrum of diseases.
- all about Vasoconstriction (incr SVR)
- problem: Vasoconstriction everywhere, affecting brain & baby :baby::skin-tone-2:
- Review ∆ types of HTN separating benign disease
Cost Benefit of Delivery
Risk
Mortality/ Morbidity
- more severe disease = more risk of death/ fetal loss
- number and severity of severe features (means the disease is progressing)
- Stability of Mom vs. Baby
Crash section performed when Mom & baby are near death
Benefit
Fetal development
- at 37wk (term) = no benefit to continued pregnancy
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