hypertension in pregnancy

28 yrs old primi at 38 weeks in early labor the CTG is reactive in admission. her nurse steps out for a moment and returns to find her having seizure. the nurse administers a bolus of Mg sulfate the seizure stops. the CTG shows absent baseline variability but there are no deceleration an the baseline is 130/min what would your next therapy be aimed at ?

• reducing pedal edema with diuretics

• give anti-htn until BP <110/70.

• prepare immediate delivary by c/s

• keeping the patient free of convulsion , acidosis and coma

which of the following will be the warning sign for her condition? (Sign of impending eclampsia)

• degree of proteinuria

• severe throbbing headache or blurred vision

• facial edema

• BP>170/120

The longer the women stays in state of eclampsia , the more risk of maternal morbidity and mortality. The women is most at risk for mortality for which of the following complications ?

• Sepsis

• Uremia

• congestive heart failure

• cerebral hemorrhage

women with eclampsia and preeclampsia when compared to normal pregnant women will have decrease in which of the following ?

• plasma volume

• liver enzymes

• uric acid

• serum creatinine

a 19 year old unbooked primigravida , term comes to ED with complains of severe headache for 2 days her RP= 90/minute , BP 150/90 mm Hg. while being examined she has a convulsion you have ordered the nurse to give a loading dose of magnisum sulfate, what is your plan meanwhile ?

• urgent US to r/o molar pregnancy.

• prepare for emergency c/s

• protect the patient airways

• give IV labetalol

loading dose of magnesium sulfate is given , she awakens from her seizure and in her post ictal state and complains of blurred vision , what is the most likely finding on fundoscopic examination?

• exudate and hemorrhage

• retinal detachment

• arteriolar spasm

• Macular degeneration

which of the following statement regarding preeclampsia is true

• it is totally preventable

• systolic rise of BP is more important that diastolic rise

• eclampsia is always preceded by acute fulminating preeclampsia

• endothelial dysfunction is the central pathology

32 year old primigravida at 39 weeks gestational age has a blood pressure reading of 150/100 obtained during routine visit. her baseline blood pressure throughout pregnancy was 120/70. the patient denies any headache, visual changes , nausea , vomiting or abdominal pain. her repeat BP 160/90. urinalysis negative for protein. which of the following is most likely diagnosis?

• pre eclampsia

• chronic htn with super-imposed preeclampsia.

• eclampsia

• gestational hypertension

32 years old primigravida came for her first ANC visit at 12 weeks . her BP 160/100 mmhg. there is no h/o hypertension pre pregnancy. Repeat BP after 4 hrs again 150/90 mm hg. there is no headache , pedal edema, blurring of vision, urine albumin +1. what is the most likely diagnosis

• pre eclampsia

• chronic hypertension

• chronic htn with super-imposed preeclampsia.

• gestational hypertension

25 years old primi at 32 weeks gestation admitted to labor ward with BP 160/110. Urine albumin +1 by urine dipstick. there is no headache , pedal edema, blurring of vision , epigastric pain or decrease urine output. NST is reactive. further management includes all except :

• send for CBC , LFT and RFT

• Start anti hypertensive medication

• immediate c/s if cervix if unfavorable.

• steroid administration