Managing Chronic Hypertension with Superimposed PE
Chronic hypertension with superimposed preeclampsia presents challenges in pregnancy management. This condition requires close monitoring of blood pressure, proteinuria levels, and symptoms to prevent complications. Early detection, proper evaluation, and timely intervention are crucial for ensuring the well-being of both the mother and baby.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
CHRONIC HYPERTENSIONWITH SUPERIMPOSED PE Donna D. Johnson, MD
CHRONIC HYPERTENSION CHRONIC HYPERTENSION HTN prior to pregnancy >140/90 prior to 20 weeks
CHRONIC HYPERTENSION CHRONIC HYPERTENSION 20-50% may develop PE 75% with ESRD Outcome worse with HTN + PE ASA 81 mg after 12 weeks
BLOOD PRESSURE CHANGES BLOOD PRESSURE CHANGES
PREGNANCY CHANGES PREGNANCY CHANGES Creatinine Creatinine Clearance Proteinuria Uric Acid Liver enzymes Platelets CBC in second trimester
DIAGNOSISING SUPERIMPOSED PE DIAGNOSISING SUPERIMPOSED PE It is not easy Often a diagnosis of exclusion
BLOOD PRESSURE BLOOD PRESSURE 28 weeks: 160/110 If not on meds: start If on low dose of one med: If maxed out on a med: + second Check BP at home See the patient often (2-3 days) Warn patient re: symptoms Give steroids Consider antenatal testing
PROTEINURIA PROTEINURIA No Baseline Proteinuria: P/C ratio Use P/C ratio to determine Baseline Proteinuria: 24 hour protein and Creatinine clearance If protein s Protein and creatinine clearance : Normal physiology Protein and creatinine clearance : Superimposed PE
LABS LABS Creatinine Uric acid Platelets LFT s
SYMPTOMS SYMPTOMS Uncontrolled headache Blurred vision Pulmonary Edema RUQ pain Vaginal bleeding Contractions
DELIVERY DELIVERY Uncontrolled HTN Worsening renal function HELLP Symptoms 37 weeks
