Professional Documents
Culture Documents
Hypertensive disorders in
pregnancy
1. Primigravidity
2. Age <20 or >35
3. Genetic or familial factors
4. Hyperplacentosis (e.g. multiple gestations, diabetes,
hydrops fetalis).
5. Hydatidiform mole
6. Polyhydramnios, chronic hypertension, chronic renal failure.
• What is the etiology of Pre-eclampsia?
1. Immunologic maladaptation.
2. Placental ischemia.
3. Genetic.
4. Prostaglandin imbalance.
• What is the Pathophysiology of Pre-eclampsia?
1. Loss of sensitivity to vasoactive substances as
angiotensin.
2. Increase in the vasoconstrictor thromboxane and
decrease in vasodilator prostacyclin.
3. This will lead to decrease perfusion to most organs
(placenta, kidneys, liver, brain, and heart)
4. Capillary injury leads to subsequent edema.
• What are the complications of Pre-eclampisa on the mother?
Increases maternal mortality.
• What are the complications of Pre-eclampisa on the fetus?
1. Prematurity (because in severe cases we have to
terminate the pregnancy).
2. Acute and chronic utero-placental insufficiency IUGR,
fetal distress, and still birth.
• A 19 year old primigravida is seen in the outpatient prenatal clinic for
routine visit. She is 32 weeks’ gestation. She has no complaints. She
has gained 1 kilogram since her last visit 2 weeks ago. On examination
her BP is 155/95, which is persistent. A spot urine dipstick is negative.
1. Kick chart
2. CTG
3. U/S
2. Give Betamethasone if less than 35 weeks’ gestation.
3. Monitor the condition
1. 6 hourly blood chart
2. Daily urine protein
3. Platelet count 2x/week
4. Uric acid 2x/week
5. Watch for symptoms of severe disease
4. Medications:
1. Hydralazine (S/E: flushing, headache, dizziness)
2. Labetalol
3. Nifedipine (S/E: severe headache and flushing)
This presentation is only to practice the mini-OSCE, do
NOT depend on it as your only source of information
for this topic.
The End
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