Obgyn: Hypertension in Pregnancy: Free MSRA Podcast

🎧 Deep Dive: Hypertension in Pregnancy – A Complete MSRA BreakdownIn this high-yield episode, we dissect Hypertension in Pregnancy from top to bottom using carefully curated MSRA revision notes. We unpack the core concepts, definitions, classifications, investigations, and management strategies to help you master this critical obstetric topic – essential not just for exams, but also real-world practice.🧠 Key Learning Points📌 Definition & Types• Hypertension = BP ≥140/90 mmHg in pregnancy• Categorised as:Chronic Hypertension: Before pregnancy or before 20 weeksGestational Hypertension (PIH): After 20 weeks, no proteinuriaPreeclampsia: After 20 weeks with proteinuria ≥0.3g/24hSevere Hypertension: ≥160/110 mmHgEclampsia: Seizures in context of preeclampsia📌 Epidemiology• Affects up to 15% of pregnancies• Preeclampsia alone: 2–8% of pregnancies• Accounts for 25% of antenatal UK admissions• 2nd leading cause of direct maternal deaths in the UK📌 Risk Factors• First pregnancy• History of preeclampsia• Chronic hypertension, kidney disease, diabetes• Autoimmune disease (SLE, antiphospholipid syndrome)• Multiple gestation• Obesity• Advanced maternal age📌 Pathophysiology• Due to abnormal placentation, leading to:Endothelial dysfunctionVasoconstrictionInflammatory & immune overactivation→ Placental insufficiency + maternal hypertension📌 Clinical Features• Headaches• Visual changes (blurred vision, flashing lights)• Right upper quadrant/epigastric pain• Proteinuria• Oedema (less used diagnostically)• Seizures = Eclampsia• Fetal signs: Reduced growth, abnormal Dopplers📌 Diagnosis Criteria✔️ Hypertension: ≥140/90 mmHg on 2 readings 4-6 hours apart✔️ Preeclampsia = Hypertension + proteinuria ≥0.3g/day✔️ PIH = Hypertension after 20w, no proteinuria✔️ Severe HTN = ≥160/110 mmHg✔️ Persisting BP ≥12 weeks postpartum = Chronic HTN📌 Investigations🧪 BP monitoring + 24h urine or protein:creatinine ratio🧪 Bloods: FBC (platelets), U+Es, LFTs🧪 Fetal USS: growth, Dopplers🧪 Home monitoring to rule out white coat hypertension📌 Management Overview👶 Mild HTN → monitor closely🚨 Severe HTN or preeclampsia → hospital admission💊 First-line meds:LabetalolNifedipine (if labetalol unsuitable)🧴 Prevention:Aspirin (75–150mg) for high-risk patientsConsider calcium (limited evidence)📌 Timing of Delivery• Aim for term (≥37w) in mild cases• Earlier if unstable or severe (sometimes from 34w)• Always balance maternal & fetal risk📌 Prognosis• With good management, mild–moderate cases often do well• BUT:40% of PIH → develop preeclampsiaLong-term ↑ risk of chronic hypertension and cardiovascular diseaseRequires ongoing follow-up postpartum📌 Complications• Maternal:EclampsiaStrokeDICPlacental abruptionFuture CV disease• Fetal:IUGRPreterm birthStillbirthNICU admission📎 More MSRA Resources on Hypertension in Pregnancy📝 Revision Notes: https://www.passthemsra.com/topic/hypertension-in-pregnancy-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/hypertension-in-pregnancy-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/hypertension-in-pregnancy-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/hypertension-in-pregnancy-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/🧪 Quiz Bank: https://www.passthemsra.com/quizzes/hypertension-in-pregnancy/🔖 Hashtags#MSRA #HypertensionInPregnancy #Preeclampsia #MSRAFlashcards #MSRARevisionNotes #PassTheMSRA #FreeMSRA #MSRAAccordions #ObstetricsAndGynaecology #PregnancyCare #MaternalMedicine #Labetalol #Eclampsia #MSRAQuiz #NICEGuidelines