Hypertensive disorder

1. pre-eclampsia
2. chronic HPT
3. pregnancy induced HPT
Dr. Latifah
 1. Pre-eclampsia (PE)
• Pre-eclampsia-
-BP >140/90mmhg on two occassions
-after 20th WOG
-significant proteinuria (>300g/24hr)
• Imminent eclampsia
-transitional state
-inc sign and sx
• Eclampsia
-pre-eclampsia with seizure
Mild PE Moderate PE Severe PE

≥160/110mmHg
 Sign & symptoms
• Headache
• Generalized oedema(esp: hands and face)
• Blurring of vision
• RUQ pain
• Ascites
• Weight gain
 Complications
• During Pregnancy
-HELLP syndrome

• Maternal
-

• Fetal
-IUGR
-preterm birth
 Investigation
• Urine dipstick
• 24hr urine protein
• PE profile
- serum AST/ALT
- uric acid
-
 Management
• Monitor BP
• Monitor proteinuria
• Monitor sx of IE
• Give antiHPT(methyldopa/ / )
 Long case tips: History and PE
• HISTORY
- how much was the BP measured
- @ how many weeks dx
- Any proteinuria upon investigation at time of dx?
- Any investigation done
- Sign and sx
oedema sx swelling of hand, face, weight gain,
ascites
High bp sx headache and RUQ pain
 Presentation tips
• Ex: chief complaint
- Madam AS, 42 y/o malay lady, G2P1 @30weeks of
gestation(WOG) was admitted 4days ago d/t high
blood pressure.
(* do not say admitted d/t PE)

• Provisional dx
-my provisional dx is pre-eclampsia bcoz the pt have
high bp, proteinuria upon investigation, and other
symptoms such as non-dependant edema, RUQ pain
and headache