Hypertensive disorders in pregnancy… HELLP! Post Test

Approximately what percentage of pregnancies are complicated by pre-eclampsia?

Which of these is true of pre-eclampsia?

A 39-year-old pregnant woman (G2P1 34/40) presented to ED with a 3-day history of headache.
Past medical history included type 2 diabetes and obesity.

Her BP at triage is 155/95 and you suspect that she may have pre-eclampsia.

Which one of the following is not known to be a risk factor for developing pre-eclampsia?

A 24-year-old pregnant woman (G1P0, 38/40) presented to ED with RUQ pain and generalised oedema.

Her BP at triage is 150/90.

Which of the following is not a recognised symptom of pre-eclampsia?

A 30-year-old pregnant woman (G3P2, 30/40) was referred to ED by her GP ?pulmonary embolism.

The BP was 149/89 at triage and the FY2 who has seen the patient is concerned that she may have pre-eclampsia.

For the purpose of diagnosing pre-eclampsia, a new onset persistent blood pressure above which threshold meets the criteria for pre-eclampsia in combination with significant proteinuria?

A 25-year-old pregnant woman (G1P0 38/40) presents to ED with severe headache. Her BP is high at triage and you suspect pre-eclampsia.

In a patient with new onset hypertension and proteinuria beyond 20 weeks of gestation, which of these would indicate the patient has severe pre-eclampsia? (Select all that apply)

You decide the previous patient has severe pre-eclampsia (a 25-year-old G1P0 38/40 who presented with headache). You try to speak to the obstetric team, but they are currently in theatre with an emergency and are not available for advice. You decide to start treatment in the interim.

Which drug would you choose as first line anti-hypertensive medication? (Select all that apply)

The same patient (a 25-year-old G1P0 38/40 with suspected severe pre-eclampsia) goes on to have a seizure whilst awaiting obstetric review. She has no history of epilepsy or previous seizures.

Other than oxygen and airway support what initial treatment would you give?

A 35-year-old pregnant woman (G1P0 38/40) presents to ED with RUQ pain and vomiting. She is afebrile, has a BP of 150/90, and urinalysis reveals 1+ protein.

Which of the following blood test results would be in keeping with HELLP syndrome? (Select all that apply)

A 29-year-old woman presents to ED 2 days post normal vaginal delivery following an unremarkable pregnancy with headache, vomiting and feeling short of breath.

BP 165/95, HR 90, RR 24, O2 sats 94% RA, temp 36.0.

ECG normal sinus rhythm. Urinalysis pending.

Which of the following is the most likely diagnosis?