Gestational Hypertension

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Gestational Hypertension by Mind Map: Gestational Hypertension

1. Pathophysiology

1.1. Mechanisms are a little unclear

1.2. Reduced placental perfusion

1.2.1. Widespread dysfunction of maternal vascular endothelium

1.2.1.1. Enhanced formation of endothelin (vasoconstricting peptides) and thromboxane (hormone that induces platelet aggregation and artery constriction)

1.2.1.2. Increased sensitivity to angiotensin II

1.2.1.3. Decreased formation of vasodilators (Nitric oxide and prostacyclin)

2. Signs & Symptoms

2.1. Headache that doesn't go away

2.2. Edema (swelling)

2.3. Sudden weight gain

2.4. Blurry/Double vision

2.5. Nausea/Vomiting

2.6. Pain in the upper right side of belly

2.6.1. Pain around stomach

2.7. Voiding small amounts of urine

3. Diagnostic Tools

3.1. Blood Pressure Readings

3.2. Urine Test

3.2.1. Checking for protein

3.2.1.1. If protein is present, sign of kidney problems

3.3. Monitoring weight changes

3.4. Liver function tests

3.5. Kidney function tests

3.6. Blood clotting tests

4. Treatment

4.1. GOAL: Avoid complications

4.2. Blood Pressure Monitoring

4.3. Fetal Monitoring

4.3.1. Fetal movement counting

4.3.2. Nonstress Testing

4.3.3. Biophysical Profile

4.3.4. Doppler Flow Studies

4.4. Lab Testing

4.4.1. Urine Monitoring

4.4.2. Blood Testing

4.5. Medication

4.5.1. Short Term Drug Therapy

4.5.1.1. Labetalol (Beta Blocker)

4.5.1.2. Hydralazine

4.5.1.3. Sustained release nifedipine (Calcium Channel blocker)

4.5.1.4. Immediate release nicardipine (Calcium Channel Blocker)

4.5.2. Long Term Drug Therapy

4.5.2.1. Methyldopa

4.5.2.2. Long acting calcium channel blockers (nifedipine)

4.6. Bed Rest/Restricted Activity

5. Preeclampsia

5.1. HTN

5.2. Signs of damage to another organ system

5.2.1. Liver Damage

5.2.2. Kidney Damage

5.3. Can cause blood clotting issues

5.4. Pulmonary edema

5.5. Seizures

5.6. Severe forms left untreated can cause maternal or infant death

6. Eclampsia

6.1. Complication of severe preeclampsia

6.2. HTN results in seizures

6.3. Unexplained coma during pregnancy