COMPLICATIONS PREGNANCY

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Questions and Answers

What defines pre-eclampsia during pregnancy?

Hypertension greater than $140/90$ mmHg with proteinuria (correct)

Increased heart rate and low blood pressure

Severe abdominal pain without hypertension

Sudden weight loss and nausea

Which of the following indicates organ dysfunction in a pregnant woman with pre-eclampsia?

Normal blood pressure readings

Increased fetal movement

Proteinuria (correct)

Lower abdominal cramps

What is a major risk factor for developing pre-eclampsia?

Having a healthy body mass index

Having a family history of pre-eclampsia (correct)

High levels of physical activity

Being under 20 years old

What should be the first step in the management of suspected pre-eclampsia?

ABCDE assessment followed by reporting findings Signup and view all the answers

What is the main complication of severe pre-eclampsia that can lead to severe outcomes?

Sub-arachnoid hemorrhage and stroke Signup and view all the answers

What characterizes eclampsia during pregnancy?

New onset of convulsions during pregnancy or postpartum Signup and view all the answers

Which position is recommended during the conveyance of a patient with suspected pre-eclampsia?

Right or left lateral positioning Signup and view all the answers

How often should blood pressure be monitored during the conveyance of a pre-eclampsia patient?

Continuously Signup and view all the answers

What is a critical indication to pre-alert an obstetric unit?

The patient shows 1 red flag or 2 amber flags Signup and view all the answers

Why are maternity patients more susceptible to infection during pregnancy?

Reduced immunity Signup and view all the answers

What management approach should be taken if a patient presents with suspected sepsis in pregnancy?

Pre-alert the nearest obstetric unit for timely care Signup and view all the answers

What should be done if a pregnant woman has ongoing life-threatening hemorrhage?

Convey her to the emergency department Signup and view all the answers

What is the time-sensitive action when sepsis is suspected in a maternity patient?

Antibiotics should be administered within an hour Signup and view all the answers

What is a key risk factor for maternal sepsis?

Presence of viral infections like influenza Signup and view all the answers

How should suspected pre-eclampsia be managed at the scene?

Use the maternity assessment card for guidance Signup and view all the answers

Which scenario does NOT warrant immediate attention in a maternity patient?

Presence of a single amber flag Signup and view all the answers

Study Notes

Pre-eclampsia

Characterized by new hypertension (≥140/90 mmHg) and proteinuria after 20 weeks of gestation.
Proteinuria indicates organ dysfunction.
Risk factors include:
- First pregnancy
- Age 40 or older
- Pregnancy interval more than 10 years
- Body mass index of 35 or higher
- Family history of pre-eclampsia
- Multiple pregnancy
- Pre-existing medical conditions (hypertension, renal or cardiac disease, diabetes).

Management of Pre-eclampsia

Conduct an ABCDE assessment and report findings.
Identify time-critical features/red flags; pre-alert to the nearest obstetric unit if present.
If no urgent features, continue thorough assessment.
During transport:
- Position patient in right or left lateral position.
- Monitor blood pressure continuously.
Severe pre-eclampsia can lead to life-threatening conditions such as sub-arachnoid hemorrhage and stroke.

Eclampsia

Defined by new onset convulsions during pregnancy or postpartum, typically in cases of pre-eclampsia.
Presents as tonic/clonic convulsions; seizures are brief.
Requires IV access and medication if paramedics are on site.

Maternal Sepsis

Ante-partum and post-partum sepsis are significant causes of maternal mortality in the UK.
Can have direct causes related to pregnancy or indirect causes (e.g., influenza, COVID-19).
Pregnant women have reduced immunity, increasing infection risk.
Rapid onset is common.

Management of Suspected Sepsis

NEWS2 is not validated for assessing sepsis in pregnancy; use the Maternity Assessment Card to check for red flags.
Pre-alert the obstetric unit; antibiotics must be administered within one hour of suspected sepsis onset.
Red flags or two amber flags indicate critical condition.
Transport to maternity unit if ≥20 weeks gestation and stable; otherwise, convey to ED if <20 weeks or unstable.

Summary of Key Actions

Continuous assessment for suspected pre-eclampsia until patient handover at the hospital.
Utilize the maternal assessment card to direct assessment and management of pregnancy complications.
Request additional resources promptly without scene delays.
Avoid calling a midwife in the presence of red flags to prevent care delays, unless the patient opts not to transfer.
Document all cases of pregnancy complications on Datix.

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Description

This quiz covers critical aspects of pre-eclampsia and eclampsia, including risk factors, management protocols, and potential complications. It is essential for healthcare professionals to understand these conditions to provide optimal care to pregnant patients. Assess your knowledge on this important topic in obstetrics.