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Pre-Eclampsia and HELLP Syndrome - Coggle Diagram
Pre-Eclampsia and HELLP Syndrome
Definition
BP >140
Greater than 20 weeks gestation
Proteinuria >0.3g/day
Pathophysiology
Abnormal placentation
failure of trophoblastic invasion
Hypoperfusion adn ischaemia
Endothelial dysfunction
excess thomboxane A2
Deficient protacylin
Platelet aggregation
Vasoconstriction
Clinical features
CNS
Headache
Visual disturbance
Clonus
Papilloedema
Seizures
GI
Epigastric pain
Vomiting
RUQ tenderness
Elevated liver enzymes ALT/ASt >70
Haematological
PLts <100
Haemolysis
Management
Medical
Magnesium
4g over 5 minutes, 1g/hour for 24 hours
MAGPIE trial = halves progression to seizures
Monitor deep tendon reflexes
Antihypertensive therapy
Nifidepine
HYdralazine
Labetolol
BP <150
Conservative
Restrictive fluid
0.5ml/kg/hr
Aim UO 05.ml/kg/hr
MDT input
Monitoring on HDU
Reverse coagulopathy
Surgical
Deliver the placenta and the baby
Steriods should be given if <34 weeks
Complications
Maternal
Eclamsia
Renal Failure
VTE
HELLP
Mississipi Classification
Mild, Moderate, Severe
PLatelets, ALT, AST, LDH, bleeding
Triad of Haemolysis, Elevated Liver enzymes and Low PLatelets
Intracranial haemorrhage
Acute fatty liver of pregnancy
AKI
Encephalopathy
Pathophysiology = impaired fatty acid oxidation due to impairment of enzymes (mitochondrial dysfunction)
Swansea criteria
Hypoglycaemia
Jaundice
Transient diabetes insipidus
Treated with NAC
Fetal
IUGR
Pre-term delivery
Fetal death
PLacental abruption