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HELLP syndrome
Acronym used to designate the changes in labs that can occur as a complication of
severe preeclampsia
preeclampsia
Multisystem hypertensive disease unique to pregnancy - concerned about seizures
preeclampsia maternal disease & s/sx onset
Inflammatory response triggered leading to endothelial damage, vasospasm, altered
hemostasis & activation of the coagulation system affecting the brain, liver, kidneys &
vascular system - results in high BP
early-onset of preeclampsia
< 34 weeks gestation & associated with more SEVERE disease
late-onset of preeclampsia
> 34 weeks gestation, more favorable maternal & fetal outcomes
is there an antidote for magnesium sulfate?
yes, calcium
preeclampsia medications
- Magnesium Sulfate
- Antihypertensives
,- Anticonvulsants
avoid antihypertensives with clients who have
asthma/HF
BPP: batman
B - breathing
A - amniotic fluid volume
T - tone
M - movement
A - and
N - NST
preeclampsia primary goal
control BP and prevent seizures & cerebral hemorrhage
Induced birth is indicated
avoid taking Magnesium sulfate with clients who have
pulmonary edema
new-onset post pregnancy preeclampsia
post pregnancy HTN development
preeclampsia risks to baby
- IUGR
- prematurity
- intolerance to labor d/t ↓ placental perfusion
- stillbirth
↑ risk for disease as an adult d/t IUGR
preeclampsia risks to mom
- cerebral edema/hemorrhage/stroke
- disseminated intravascular coagulation (DIC)
- pulmonary edema
,- congestive HF
- abruptio placenta
Chronic HTN
HTN (BP > 140/90) before conception
common risk factors of a high-risk pregnancy
- Pre-existing health conditions
- History of prior pregnancy complications
- Complications that arise during pregnancy
- Obesity, high BMI, excessive weight gain
- Multiple gestation
- Age < 18 or advanced maternal age > 35
pregestational diabetes - risks to mother
causes a lot of cardiac problems (preeclampsia)
contributing factors to insulin resistance
Insulin desensitizing hormones produced by the placenta
screen for gestational diabetes through
urine test
gestational diabetes medical management
- managed by diet and exercise
- glycemic control
If a maternal patient has gestational diabetes what should they monitor for after birth?
what is the 2 step-screening method for gestational diabetes?
- oral glucose challenge test (screening)
- glucose tolerance test (diagnostic)
gestational diabetes routine screening is at
24-28 weeks (2nd trimester)
gestational diabetes - risks to the baby
- macrosomia
- hypoglycemia
- no congenital anomalies
Preconception care is key to
↓ risks in pregestational diabetes
too much ______ can be a teratogen and affect organ development during first 3-8 weeks
sugar
pregestational diabetes -risks to the baby
- congenital defects: hear, CNS
- growth disturbances, macrosomia
- hypoglycemia
treatment goals and management strategies for gestational diabetes
- maintain euglycemia control
- minimize complications
- prevent prematurity
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