PREECLAMPSIA
- A pregnancy affected by high blood pressure and proteinuria that develop after 20 weeks
in a woman previously does not have the condition
Risk factors:
- Multifetal pregnancy
- Maternal age (older)
- History of hypertension or history of preeclampsia from previous birth
- Obesity–increases BP and HR to compensate for workload
- Diabetes
- Hypertension
- Renal disease
- Null parity
Ecclampsia: if patient has developed seizure activity as evidenced by hyperreflexia (DTR ↑2),
positive ankle clonus, jitters or shaking (CNS irritability), spotty vision or double vision
- Irritated CNS can lead to seizure activity
HELLP syndrome: Hemolysis, Elevated Liver enzyme, Low Platelets
- Manifestations: epigastric pain, low platelet level, bleeding/hemorrhaging
- HELLP is not consistent with preeclampsia, some patients doesn;t develop it
- Check CMP and coag (PTT/INR/PT)
Fetal complications:
- Tachycardia
- Late decels
- Decreased variability
- Poor placental perfusion (late deceleration)
- IUGR or SGA
- Adequate surfactant
Medications:
● Magnesium sulfate–prevents seizure
- Therapeutic level of 4-7
- Assess DTR (+2 is normal), maintain airway, lung sounds, LOC, BP
- IV piggyback
- Assess for 30 mL/hr of urine output
- Do not stop magnesium sulfate during seizure
- A pregnancy affected by high blood pressure and proteinuria that develop after 20 weeks
in a woman previously does not have the condition
Risk factors:
- Multifetal pregnancy
- Maternal age (older)
- History of hypertension or history of preeclampsia from previous birth
- Obesity–increases BP and HR to compensate for workload
- Diabetes
- Hypertension
- Renal disease
- Null parity
Ecclampsia: if patient has developed seizure activity as evidenced by hyperreflexia (DTR ↑2),
positive ankle clonus, jitters or shaking (CNS irritability), spotty vision or double vision
- Irritated CNS can lead to seizure activity
HELLP syndrome: Hemolysis, Elevated Liver enzyme, Low Platelets
- Manifestations: epigastric pain, low platelet level, bleeding/hemorrhaging
- HELLP is not consistent with preeclampsia, some patients doesn;t develop it
- Check CMP and coag (PTT/INR/PT)
Fetal complications:
- Tachycardia
- Late decels
- Decreased variability
- Poor placental perfusion (late deceleration)
- IUGR or SGA
- Adequate surfactant
Medications:
● Magnesium sulfate–prevents seizure
- Therapeutic level of 4-7
- Assess DTR (+2 is normal), maintain airway, lung sounds, LOC, BP
- IV piggyback
- Assess for 30 mL/hr of urine output
- Do not stop magnesium sulfate during seizure
