Preeclampsia

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Preeclampsia

  1. 1. Pre-eclampsia Team Ramrod Rocks!
  2. 2. Meow Here’s The Problem <ul><li>Ginger is a 17-year-old high school student </li></ul><ul><li>First pregnancy and with no prenatal care. </li></ul><ul><li>About 22 weeks pregnant </li></ul><ul><li>Recently began to gain about 2 lbs per week. </li></ul><ul><li>Hypertension (BP 140/90) </li></ul><ul><li>Has proteinuria and edema (which explains the rapid weight gain) </li></ul><ul><li>Increased serum creatinine levels </li></ul><ul><li>Decreased Renin and Aldosterone levels. </li></ul><ul><li>The doctor admits Ginger to the hospital for observation, and orders magnesium sulfate injection to be ready in case of seizure </li></ul>
  3. 3. Pre-eclampsia <ul><li>Also know as Toxemia </li></ul><ul><li>Cause is unknown, but occurs only in pregnant women </li></ul><ul><ul><li>could be related to the placenta failing to implant properly in the lining of the uterus; preventing arteries from dilating as they should, restricting blood flow and leading to a host of other problems </li></ul></ul><ul><li>No known cure (other than having the baby) </li></ul><ul><li>High risk for first pregnancies, multiple gestations, women under age 20, pre-existing hypertension, or diabetes </li></ul><ul><li>Occurs after 20 weeks gestation </li></ul><ul><li>Usually detected early with adequate prenatal care </li></ul>
  4. 4. Signs & Symptoms <ul><li>Principle Signs: </li></ul><ul><ul><li>Proteinuria (protein in urine) </li></ul></ul><ul><ul><li>Hypertension due to vasoconstriction </li></ul></ul><ul><li>Other signs & symptoms include: </li></ul><ul><ul><li>edema </li></ul></ul><ul><ul><li>rapid weight gain </li></ul></ul><ul><ul><li>∆’ s in vision </li></ul></ul><ul><ul><li>HELLP syndrome (20% of women with severe pre-eclampsia) </li></ul></ul><ul><ul><ul><li>H emolysis (breakdown of RBC) E levated L iver enzymes, and L ow P latelets </li></ul></ul></ul><ul><li>Rapid progression of Pre -eclampsia may not show such symptoms. </li></ul>
  5. 5. Decrease in Renin and Aldosterone due to high BP
  6. 6. Increased Levels of Creatinine <ul><li>Creatinine is a non-protein waste product of creatine phosphate metabolism by skeletal muscle tissue. </li></ul><ul><li>Vasoconstriction leads to a decrease in blood flow to organs, including the kidneys. The result is decreased filtration rates of this byproduct and potential renal failure. </li></ul>
  7. 7. Magnesium Sulfate Injections <ul><li>Pre-eclampsia can lead to eclampsia (uncontrolled convulsions & dangerous HTN). </li></ul><ul><li>The control of convulsions is the most important aspect in the management of eclampsia , and MgSO 4 is a very effective anticonvulsant. </li></ul><ul><li>This drug works by inhibiting Ach release at the neuromuscular junction, thereby reducing striated muscular contraction. </li></ul>
  8. 8. Why do we care meow? <ul><li>Leading global cause of maternal and infant illness and death. </li></ul><ul><li>Conservative estimates of 76,000 deaths per year </li></ul><ul><li>Pre-eclampsia occurs in approximately 5-8% of pregnancies </li></ul>
  9. 9. How does this affect mom and baby? <ul><li>Can kill or harm the baby because of the placenta receiving too little blood flow and oxygen. </li></ul><ul><li>Can cause low birth weight. </li></ul><ul><li>Ideally, you can induce labor if late enough in the pregnancy. </li></ul><ul><li>Otherwise, bed rest and constant observation. </li></ul>
  10. 10. “I Can’t Pull Over Any Farther” <ul><li>Pre-eclampsia is like physiology class </li></ul><ul><li>You get about halfway through the class (pregnancy) when you get your midterm grade back (pre-eclampsia) </li></ul><ul><li>To save your G.P.A. (fetus) you may drop the class (induced labor) or study more and finish the class (with bed rest) or make some Sangria for Janice (taking blood pressure medication) </li></ul>
  11. 11. Questions? Questions?

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