OB DAY 4

140/90 mmHg

What BP reading indicates pregnancy-induced hypertension (PIH)?

Systolic +30 mmHg or Diastolic +15 mmHg

What change in blood pressure from baseline indicates PIH?

• At least 6 hours apart

How far apart must elevated BP readings be taken to diagnose PIH?

At every prenatal visit

When is BP screening for PIH usually checked?

ACE inhibitors and ARBs

What antihypertensive drugs are contraindicated in pregnancy due to fetal kidney damage?

Methyldopa

Which antihypertensive drug is considered safe and has no effect on the baby?

Hydralazine (Apresoline)

What is the best IV vasodilator used acutely in pregnancy-induced hypertension?

Nifedipine

Which oral antihypertensive is a calcium channel blocker safe for pregnancy?

Labetalol

What beta-blocker is considered safe in pregnancy?

Diastolic should not go below 88 mmHg

What is the minimum diastolic BP level that should be maintained in PIH management?

Pre Eclampsia

Complicated hypertension in pregnancy with renal involvement

Proteinuria

What urine finding is associated with preeclampsia?

Decreased urinary output (oliguria)

What indicates renal involvement in preeclampsia?

Cerebral edema

What type of edema is most concerning in preeclampsia?

irritability

What sign may indicate cerebral edema in preeclampsia?

Bright lights, noise, and stimulation (to prevent seizures)

What environmental factors should be eliminated in managing eclampsia?

Convulsions/seizures

What is a critical complication of eclampsia?

Prevention via BP control and magnesium sulfate

What is the key strategy to prevent convulsions in eclampsia?

To lower BP and prevent complications

What is the goal of antihypertensive treatment in preeclampsia?

BP: 160/110 mmHg, Proteinuria: +3 to +4

What BP and proteinuria values suggest severe preeclampsia?

At least 30 ml/hr

What is the minimum urine output to assess for kidney function in preeclampsia?

Patellar reflex (to assess for toxicity)

What reflex is monitored when administering magnesium sulfate?

RAAS (Renin-Angiotensin-Aldosterone System)

What hormone system is activated in preeclampsia that contributes to high BP?

Sodium (due to water retention)

What electrolyte should be restricted in preeclampsia?

Severe Pre-eclampsia
Risk of MgSo4 toxicity
Hypermagnesemia sign

If below 30 ml of IO it can result in

5-8 mg/dl

Therapeutic range of MgSo4

2

Goal for DTR

12

Respiratory Rate limit for MgSo4

calcium gluconate

Antidote for magnesium sulfate

Eclampsia

Most severe gestational hypertension

Padded side rails, lower bed, side-lying position

What immediate safety measures should be done during an eclamptic seizure?

Tonic-clonic (generalized)

What kind of seizure occurs in eclampsia?

Diazepam (as emergency anticonvulsant)

What drug may be used to stop an ongoing seizure in eclampsia?

To drain secretions and improve fetal circulation

Why is the left side-lying position recommended for eclamptic patients?

Fetal heart rate (FHR), rule out placental abruption

What key fetal assessments are done during an eclampsia episode?

Continued to prevent recurrent seizures

What is the role of magnesium sulfate in eclampsia?

O₂ at 8–10 L/min via face mask

What is the maternal oxygen support for eclamptic patients in preterm labor?

SpO₂ (oxygen saturation)

What should be checked frequently during labor in eclamptic patients?

NPO

What is the fluid and diet order for a patient with eclampsia?

Placental abruption

What serious complication is associated with bleeding in eclampsia?

HELLP Syndrome (Hemolysis, Elevated Liver enzymes, Low Platelet count)

What syndrome involves bleeding, liver involvement, and low platelets in eclampsia?

AST and ALT (liver enzymes)

What enzymes are elevated in HELLP syndrome?

20%

What is the maternal mortality rate associated with eclampsia?

35%

What is the fetal mortality rate associated with eclampsia?

Cerebral Hypoxia
Injuries

What are the two major risks associated with eclampsia?