Preeclampsia

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Pre-eclampsia

• Team Ramrod Rocks!

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Meow Heres The Problem

• Ginger is a 17-year-old high school student
• First pregnancy and with no prenatal care.
• About 22 weeks pregnant
• Recently began to gain about 2 lbs per week.
• Hypertension (BP 140/90)
• Has proteinuria and edema (which explains the
  rapid weight gain)
• Increased serum creatinine levels
• Decreased Renin and Aldosterone levels.
• The doctor admits Ginger to the hospital for
  observation, and orders magnesium sulfate
  injection to be ready in case of seizure

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Pre-eclampsia

• Also know as Toxemia
• Cause is unknown, but occurs only in pregnant
  women
• 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
• No known cure (other than having the baby)
• High risk for first pregnancies, multiple
  gestations, women under age 20, pre-existing
  hypertension, or diabetes
• Occurs after 20 weeks gestation
• Usually detected early with adequate prenatal care

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Signs Symptoms

• Principle Signs
• Proteinuria (protein in urine)
• Hypertension due to vasoconstriction
• Other signs symptoms include
• edema
• rapid weight gain
• ?s in vision
• HELLP syndrome (20 of women with severe
  pre-eclampsia)
• Hemolysis (breakdown of RBC) Elevated Liver
  enzymes, and Low Platelets
• Rapid progression of Pre-eclampsia may not show
  such symptoms.

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Decrease in Renin and Aldosterone due to high BP
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Increased Levels of Creatinine

• Creatinine is a non-protein waste product of
  creatine phosphate metabolism by skeletal muscle
  tissue.
• 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.

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Magnesium Sulfate Injections

• Pre-eclampsia can lead to eclampsia (uncontrolled
  convulsions dangerous HTN).
• The control of convulsions is the most important
  aspect in the management of eclampsia, and MgSO4
  is a very effective anticonvulsant.
• This drug works by inhibiting Ach release at the
  neuromuscular junction, thereby reducing striated
  muscular contraction.

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Why do we care meow?

• Leading global cause of maternal and infant
  illness and death.
• Conservative estimates of 76,000 deaths per year
• Pre-eclampsia occurs in approximately 5-8 of
  pregnancies

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How does this affect mom and baby?

• Can kill or harm the baby because of the placenta
  receiving too little blood flow and oxygen.
• Can cause low birth weight.
• Ideally, you can induce labor if late enough in
  the pregnancy.
• Otherwise, bed rest and constant observation.

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I Cant Pull Over Any Farther

• Pre-eclampsia is like physiology class
• You get about halfway through the class
  (pregnancy) when you get your midterm grade back
  (pre-eclampsia)
• 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)

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Questions?
Questions?