HTN DISORDERS OF PREGNANCY | GUARANTEED SUCCESS
STARTS HERE! LEARN, PRACTICE & EXCEL!
Associated risks for babies from maternal HTN Answer: - fetal growth restriction
- preterm birth
- placental abruption
- adverse effects of medications (magnesium toxicity)
Additional risk associated with pre-E/Eclampsia for paretn Answer: - seizures
- stroke
- DIC
Long-term risk associated with pre-E/Eclampsia for parent Answer: - increased risk for
cardiovascular, renal, and chronic hypertensive disease
Too small of blood pressure cuff Answer: - raises BP as much as 10 to 20 mmHg
Chronic hypertension in pregnancy Answer: - HTN diagnosed prior to pregnancy OR
- developes prior to 20 weeks
- BP greater than or equal to 140 and/or 90
on at least 2 separate occasion > 4 hours apart
Chronic HTN post pregnancy Answer: persists longer than 12 weeks PP
Antepartum Management of Patients with Chronic Hypertension Answer: - HELLP labs at initial
visit
- home blood pressure monitoring
- if uncontrolled, may need more frequent visits
Medical management of chronic htn in pregnancy Answer: - treat chronic htn if greater than or
equal to 140 and/or 90
- cont. beta or calcium channel blockers
- labetalol, extended release nifedipine, methyldopa
Labetalol for severe range hypertension dose Answer: 20 mg IV
Labetalol indications Answer: - give immediately for severe range blood pressures
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, - Systolic BP >160 and/or Diastolic BP > 110
- adresses stroke risk
Labetalol contrainidactions Answer: - asthma
- pts with HR < 60
ACE inhibitors and angiotensin II receptor blockers for chronic htn Answer: contraindicated in
pregnancy!
CHTN well controlled w/o meds plan Answer: - IOL between 38-39 weeks
- baseline HELLP labs
CHTN well controlled on meds plan Answer: - IOL at 38 weeks
- baseline HELLP labs at NOB
- weekly NST/MVP starting at 32 weeks
- growth US at 28-32 weeks, and 34-36 weeks
Gestational HTN Answer: - New onset HTN after 20 weeks of pregnancy and resolves by the
12th week PP
- Elevated systolic BP of > 140 or diastolic BP> 90 on two separate occasions > 4 hours apart
AND
- No s/s of pre-eclampsia, abnormal labs, or proteinuria
Gestational HTN mngmnt Answer: - weekly HELLP labs to r/o pre-e
- Induction of labor at 37 weeks if have not developed pre-eclampsia
Etiology of pre-e Answer: - Exact mechanism of the pathogenesis is unknown
- related to placenta and an exaggerated inflammatory response
Pre-E risk factors Answer: - Pre-eclampsia in a previous pregnancy
- DM, HTN, renal disease, SLE/automimmune, hypercoaguability
- first pregnancy or new paternity
- < 18 and > 35 years
- obesity (BMI > 30)
- multiple gestation
- pre-E in 1st degree relative
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
STARTS HERE! LEARN, PRACTICE & EXCEL!
Associated risks for babies from maternal HTN Answer: - fetal growth restriction
- preterm birth
- placental abruption
- adverse effects of medications (magnesium toxicity)
Additional risk associated with pre-E/Eclampsia for paretn Answer: - seizures
- stroke
- DIC
Long-term risk associated with pre-E/Eclampsia for parent Answer: - increased risk for
cardiovascular, renal, and chronic hypertensive disease
Too small of blood pressure cuff Answer: - raises BP as much as 10 to 20 mmHg
Chronic hypertension in pregnancy Answer: - HTN diagnosed prior to pregnancy OR
- developes prior to 20 weeks
- BP greater than or equal to 140 and/or 90
on at least 2 separate occasion > 4 hours apart
Chronic HTN post pregnancy Answer: persists longer than 12 weeks PP
Antepartum Management of Patients with Chronic Hypertension Answer: - HELLP labs at initial
visit
- home blood pressure monitoring
- if uncontrolled, may need more frequent visits
Medical management of chronic htn in pregnancy Answer: - treat chronic htn if greater than or
equal to 140 and/or 90
- cont. beta or calcium channel blockers
- labetalol, extended release nifedipine, methyldopa
Labetalol for severe range hypertension dose Answer: 20 mg IV
Labetalol indications Answer: - give immediately for severe range blood pressures
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, - Systolic BP >160 and/or Diastolic BP > 110
- adresses stroke risk
Labetalol contrainidactions Answer: - asthma
- pts with HR < 60
ACE inhibitors and angiotensin II receptor blockers for chronic htn Answer: contraindicated in
pregnancy!
CHTN well controlled w/o meds plan Answer: - IOL between 38-39 weeks
- baseline HELLP labs
CHTN well controlled on meds plan Answer: - IOL at 38 weeks
- baseline HELLP labs at NOB
- weekly NST/MVP starting at 32 weeks
- growth US at 28-32 weeks, and 34-36 weeks
Gestational HTN Answer: - New onset HTN after 20 weeks of pregnancy and resolves by the
12th week PP
- Elevated systolic BP of > 140 or diastolic BP> 90 on two separate occasions > 4 hours apart
AND
- No s/s of pre-eclampsia, abnormal labs, or proteinuria
Gestational HTN mngmnt Answer: - weekly HELLP labs to r/o pre-e
- Induction of labor at 37 weeks if have not developed pre-eclampsia
Etiology of pre-e Answer: - Exact mechanism of the pathogenesis is unknown
- related to placenta and an exaggerated inflammatory response
Pre-E risk factors Answer: - Pre-eclampsia in a previous pregnancy
- DM, HTN, renal disease, SLE/automimmune, hypercoaguability
- first pregnancy or new paternity
- < 18 and > 35 years
- obesity (BMI > 30)
- multiple gestation
- pre-E in 1st degree relative
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
