Hypertension and Preeclampsia in Pregnancy

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Questions and Answers

At what week of pregnancy does preeclampsia typically develop?

After week 30

Before week 10

At the end of the 2nd trimester

Between weeks 20 and the end of the 1st week of delivery (correct)

What is the diagnostic criterion for significant proteinuria in preeclampsia?

1+ on a dipstick test

A protein-creatinine ratio >100 mg/mmol

>300 mg protein in a 24-hour urine sample (correct)

2+ on a dipstick test

What is a neurological problem associated with preeclampsia?

Mental retardation

Hypertension

Convulsions (eclampsia) (correct)

Diabetes

What is the risk factor for preeclampsia?

First pregnancy Signup and view all the answers

What is the complication of untreated preeclampsia?

Coma Signup and view all the answers

What is the approximate percentage of women who develop preeclampsia?

5% Signup and view all the answers

What is the condition when a woman with preeclampsia develops convulsions?

Eclampsia Signup and view all the answers

What is the risk factor for Rh incompatibility?

Mother has Rh-negative blood, and the baby has Rh-positive blood Signup and view all the answers

What percentage of the population had diabetes according to the NHMS in 2015?

17.5% Signup and view all the answers

What is the diagnostic criteria for overt diabetes?

FPG ≥ 7.0 mmol/L Signup and view all the answers

What is the primary goal of screening for diabetes?

To identify asymptomatic patients who may have overt diabetes Signup and view all the answers

What percentage of women with gestational diabetes will develop diabetes after delivery?

50% Signup and view all the answers

What is the definition of gestational hypertension?

Systolic BP > 140mmHg and/or diastolic BP > 90mmHg Signup and view all the answers

When is gestational hypertension typically detected?

After 20 weeks of pregnancy Signup and view all the answers

What is the classification of hypertension during pregnancy?

Preeclampsia-eclampsia, gestational hypertension, and chronic hypertension Signup and view all the answers

What can help overcome gestational diabetes?

Dietary measures and controlling sugar levels Signup and view all the answers

What is the primary reason for increased daily iron requirement during pregnancy?

To compensate for the lack of iron in the diet Signup and view all the answers

What is the main cause of urinary tract infections during pregnancy?

Slowed down urine flow due to the enlarging uterus Signup and view all the answers

What is the estimated percentage of women who will experience acute symptomatic UTIs during pregnancy?

2% of women Signup and view all the answers

What is the primary complication of placenta praevia?

Risk of hemorrhage Signup and view all the answers

What is the percentage of cases where placenta praevia corrects itself by the 2nd semester?

90% of cases Signup and view all the answers

What is the primary cause of placenta abruption?

The premature separation of the placenta from the womb Signup and view all the answers

What is the incidence of placenta praevia in deliveries?

1 in 200 deliveries Signup and view all the answers

What is the primary complication of gestational hypertension?

Preeclampsia Signup and view all the answers

Study Notes

Hypertension in Pregnancy

Chronic hypertension can be classified into two categories: chronic hypertension (of any cause) and chronic hypertension with superimposed preeclampsia.
Preeclampsia is clinically diagnosed hypertension that develops after 20 weeks of pregnancy, accompanied by one or more of the following symptoms:
- Significant proteinuria (≥300 mg protein in a 24-hour urine sample, or a spot urine protein-creatinine ratio ≥30 mg/mmol)
- Renal insufficiency (serum creatinine ≥ 90 micromol/l or oliguria)
- Liver disease (raised transaminases and/or severe right upper quadrant or epigastric pain)
- Neurological problems (convulsions, hyperreflexia with clonus, or severe headaches and persistent visual disturbances)
- Haematological disturbances (thrombocytopenia, coagulopathy, or haemolysis)
- Fetal growth restriction
Preeclampsia typically develops between 20 weeks of pregnancy and the end of the first week of delivery, affecting around 5% of women, mostly first-time pregnancies.
Risk factors for preeclampsia include:
- First pregnancy
- Multiple pregnancy
- Previous preeclampsia
- Existing hypertension or blood vessel disorder
- Age below 15 or above 35 years

Eclampsia

Eclampsia is a serious condition that occurs due to hypertension in pregnancy, characterized by convulsions or loss of consciousness in the absence of any other underlying neurologic disorder.
It is a rare condition, usually occurring in late pregnancy, and may be accompanied by symptoms such as headaches, flashing lights, vomiting, or abdominal pain.
If left untreated, eclampsia can lead to coma.

Rhesus Disease

Rhesus disease, also known as rhesus (Rh) iso-immunization, occurs when a pregnant woman has Rh-negative blood and her baby has Rh-positive blood.
This condition is not common in the region and can lead to problems when Rh-positive blood enters the mother's bloodstream and produces antibodies (Rh sensitization).

Gestational Diabetes

Gestational diabetes is a type of diabetes that develops during pregnancy, with a prevalence of 17.5% in the region.
Screening is essential to identify asymptomatic patients who may have overt diabetes before they manifest symptoms.
The diagnosis of gestational diabetes is made when blood glucose levels are high during the first trimester, followed by a second test using fasting plasma glucose (FPG), untimed random plasma glucose (RPG), HbA1C, or OGTT to confirm the diagnosis.
Overt diabetes is suspected in the presence of at least one of the following:
- FPG ≥ 7.0 mmol/L
- RPG ≥ 11.1 mmol/L with symptoms
Gestational diabetes can be overcome through dietary measures, controlling sugar levels, and insulin injections or medication (Metformin).
50% of pregnant women with gestational diabetes will have a risk of developing diabetes after delivery.

Gestational Hypertension

Gestational hypertension, also known as pregnancy-induced hypertension (PIH), is defined as a systolic blood pressure (BP) > 140mmHg and/or a diastolic BP > 90mmHg, detected for the first time after 20 weeks of pregnancy.
It can progress to pre-eclampsia.

Other Complications of Pregnancy

Urinary tract infections (UTIs) are common during pregnancy, affecting around 2% of women.
UTIs can spread to the kidneys and cause fever and shivers, and are treated with antibiotics.
Other complications of pregnancy include placenta praevia, placenta abruption, hyperemesis gravidarum, and multiple pregnancies.
Placenta praevia is a condition where the placenta is "low lying" and covers all or part of the internal opening of the cervix, affecting around 3% of women.
Placenta abruption is the premature separation of a normally situated placenta from the wall of the womb before delivery.

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Description

This quiz covers the diagnosis and classification of hypertension and preeclampsia in pregnancy, based on the International Society for the Study of Hypertension in Pregnancy (ISSHP) guidelines. It includes the definition of chronic hypertension, superimposed preeclampsia, and clinically diagnosed hypertension.