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Hypertensive Disorders & Pregnancy

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by

Lon Nolte

on 30 July 2013

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Transcript of Hypertensive Disorders & Pregnancy

Hypertensive Disorders Pregnancy
July 30, 2013
Dr. Nolte (AKA Taff)
My Philosophy
Basic Definitions
Simple Triage Questions
Hypertension
1. Chronic Hypertension (CHTN)
2. Gestational Hypertension (GHTN)
3. Preeclampsia (PreE)
Chronic Hypertension (CHTN)
Definition:
1. Diagnosis of HTN prior to pregnancy
2. Two elevated BP before 20 wks EGA
- >6 hours apt
- SBP - 140 mmHg or >
- DBP - 90 mmHg or >
Chronic Hypertension
1. On Meds?
2. Mild or Severe?
Gestational Hypertension (GHTN)
Definition:
1. Not CHTN
2. Two Elevated BP
- SBP 140 mmHg or >
- DBP 90 mmHg or >
- >6 hrs apart
- @ 20 wks gest age or >

Preeclampsia
Definition:
GHTN +
proteinuria
1.
24 hour urine protein
- 300 mg or greater, but less than 5 grams
2.
Persistent 1+ (30 mg/dL) on dipstick
3.
Random protein:creatinine ratio >30 mg/mmol
Eclampsia
Definition: tonic-clonic seizure due to preeclampsia or gestational HTN
Hypertensive Crisis
Definition: severe symptomatic elevation in BP with evidence of acute target organ damage

My Philosophy:
Practice as if you work in isolation
30 minute rule
Definitions
Blood Pressure Ranges:
Mild: SBP 140 mmHg - 159 mmHg
DBP 90 mmHg - 109 mmHg
Severe: SBP 160 mmHg or >
DBP 110 mmHg or >
DBP 105 mmHg or >
Mild or Severe?
Summary:
CHTN
GHTN
PreE
Eclampsia
Simple Triage questions:
BP - mild or severe range?
On meds?
Sx of end organ failure
Proteinuria?
916-307-7686
Full transcript