Podcast
Questions and Answers
What is a sign of pre-eclampsia?
What is a sign of pre-eclampsia?
Proteinuria in pregnancy does not indicate organ dysfunction.
Proteinuria in pregnancy does not indicate organ dysfunction.
False
What is the primary management of pre-eclampsia during conveyance?
What is the primary management of pre-eclampsia during conveyance?
Right or left lateral positioning and continuous BP measurements.
The onset of _____ during pregnancy or post-partum is characteristic of eclampsia.
The onset of _____ during pregnancy or post-partum is characteristic of eclampsia.
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Which of the following is NOT a risk factor for pre-eclampsia?
Which of the following is NOT a risk factor for pre-eclampsia?
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Match the condition with its description:
Match the condition with its description:
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Eclampsia can present without a history of pre-eclampsia.
Eclampsia can present without a history of pre-eclampsia.
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What severe complication can arise from severe pre-eclampsia?
What severe complication can arise from severe pre-eclampsia?
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What is one leading cause of maternal mortality in the UK?
What is one leading cause of maternal mortality in the UK?
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Eclamptic seizures can last for a prolonged period of 20 weeks.
Eclamptic seizures can last for a prolonged period of 20 weeks.
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What should antibiotics for sepsis be administered within after the onset of symptoms?
What should antibiotics for sepsis be administered within after the onset of symptoms?
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Reduced immunity in pregnancy means that maternity patients are more susceptible to __________.
Reduced immunity in pregnancy means that maternity patients are more susceptible to __________.
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Match the following flags with their corresponding actions:
Match the following flags with their corresponding actions:
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It is appropriate to call a midwife in the presence of red flags.
It is appropriate to call a midwife in the presence of red flags.
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What card should be used to identify red flags during the management of suspected sepsis?
What card should be used to identify red flags during the management of suspected sepsis?
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In case of suspected pre-eclampsia, what is recommended?
In case of suspected pre-eclampsia, what is recommended?
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Study Notes
Pre-eclampsia
- Characterized by new hypertension (greater than or equal to 140/90 mmHg) and proteinuria after 20 weeks of gestation.
- Proteinuria is a sign of organ dysfunction.
- Pre-eclampsia can be life-threatening, even without seizures.
- Severe pre-eclampsia can lead to subarachnoid hemorrhage and stroke.
Symptoms of Pre-eclampsia
- Headache
- Visual disturbances
- Upper abdominal pain
- Nausea and vomiting
- Decreased urine output
- Swelling of hands and face
Risk Factors for Pre-eclampsia
- First pregnancy
- Age 40 years or older
- Pregnancy interval greater than 10 years
- Body mass index of 35 or greater
- Family history of pre-eclampsia
- Pre-eclampsia in a previous pregnancy
- Multiple pregnancy
- Medical co-morbidities (hypertension, renal or cardiac disease, diabetes)
Management of Pre-eclampsia
- Conduct ABCDE assessment and report findings.
- Pre-alert the nearest obstetric unit if there are time-critical features or red flags.
- If there are no red flags, continue with a thorough assessment.
- Position the patient on their right or left side.
- Monitor blood pressure continuously.
Eclampsia
- Characterized by new onset of convulsions during pregnancy or postpartum, typically in women with pre-eclampsia.
- Presents as a tonic-clonic convulsion.
- Treat as Eclampsia if seizure occurs after 20 weeks gestation or post-partum.
- Ensure IV access and administer drugs if a paramedic is on scene.
Maternal Sepsis
- A leading cause of maternal mortality in the UK.
- Can be direct (pregnancy or genital tract related) or indirect (influenza, COVID-19, Group A and B Strep).
- Reduced immunity during pregnancy increases susceptibility to infection.
- Can have a rapid onset.
Management of Suspected Sepsis
- NEWS2 is not validated for use in pregnancy due to maternal physiology.
- Use the Maternity Assessment Card to identify red flags.
- Pre-alert the nearest obstetric unit.
- Antibiotics need to be administered in hospital within an hour of sepsis onset.
Red Flags and Time Critical Management
- One red flag or two amber flags indicate a time-critical situation.
- Convey to a maternity unit if gestation is 20 weeks or more, and the woman is stable.
- Convey to an ED with obstetrics on site if gestation is less than 20 weeks or the woman is unstable (ongoing life-threatening hemorrhage, recent seizure, reduced GCS).
Summary
- Suspected pre-eclampsia requires close and continuous assessment.
- Utilize the Maternal Assessment Card on JRCALC+ to guide assessment and management of pregnancy complications.
- Call for additional resources early but do not delay on scene.
- Do not call a midwife in the presence of red flags.
- Report all cases of pregnancy complications in Datix.
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Description
This quiz covers the essentials of pre-eclampsia, including its definition, symptoms, risk factors, and management strategies. It aims to provide a comprehensive understanding of how to identify and handle this serious condition during pregnancy. Test your knowledge on critical features and clinical responses related to pre-eclampsia.
