Examkin

Soru

Zorluk: KolayObstetric Complications

Match each clinical description of a pregnant patient after 20 weeks gestation to the most accurate hypertensive disorder of pregnancy.

  • Blood pressure of 152/96 mm Hg, normal laboratory values, and negative urine protein.Gestational hypertension
  • Blood pressure of 165/110 mm Hg accompanied by greater than 300 mg of protein in a 24-hour urine collection.Preeclampsia
  • New-onset, unprovoked tonic-clonic seizures in a patient with a blood pressure of 155/100 mm Hg.Eclampsia
  • Blood pressure of 148/94 mm Hg, schistocytes on peripheral smear, AST of 120 U/L, and platelets of 85,000/mm³.HELLP syndrome

Cevap

The presentations are matched to their respective hypertensive disorders based on the presence or absence of proteinuria, systemic end-organ damage, hemolysis, and seizures.
Each hypertensive disorder of pregnancy has distinct, non-overlapping diagnostic criteria that must be rapidly identified for appropriate maternal and fetal triage.

Adım Adım Çözüm

1
Evaluate the patient's blood pressure and gestational age.
All patients exhibit hypertension (>140/90 mm Hg) after 20 weeks gestation, indicating a hypertensive disorder of pregnancy.
Establishing the baseline category of disease is the first diagnostic requirement.
2
Check for the presence of proteinuria or severe features.
Absence of both points to gestational hypertension; presence of proteinuria points to preeclampsia.
Proteinuria or end-organ damage differentiates simple gestational hypertension from preeclampsia.
3
Assess for life-threatening complications or specific severe variants.
Seizures indicate eclampsia. The specific triad of microangiopathic hemolysis, transaminitis, and thrombocytopenia identifies HELLP syndrome.
Identifying these severe manifestations dictates immediate management, such as magnesium sulfate administration and prompt delivery.

Anahtar Kavram

Diagnostic criteria for hypertensive disorders of pregnancy
Tahmini Süre:45s
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Obstetric Complications

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