A 34 year old woman with a history of chronic hypertension has a spontaneous vaginal delivery following induction of labour at term. Her BP is 138/88 mmHg on labetalol 200mg mg four times a day. She wishes to go home 18h after giving birth. The target for BP control should be
A. Below 140/90 mmHg -------------------- CORRECT
B. Below 150 mmHg systolic and 80-100 mmHg diastolic
C. Below 120/80 mmHg
D. Below 150/99 mmHg
E. 120-140/80-90 mmHg
A 34 year old woman with a history of chronic hypertension has a spontaneous vaginal delivery following induction of labour at term. Her BP is 138/88 mmHg on labetalol 200mg mg four times a day.
A. Continue labetalol and monitor BP at least 6 hourly for the first 48h
B. Continue labetalol and monitor BP daily for the first 2 days
C. Stop labetalol and monitor BP 6 hourly while in hospital
D. Reduce dose of labetalol to 200 mg three times a day and monitor BP 6 hourly for 48 hours
E. Reduce dose of labetalol to 200 mg three times a day and monitor BP daily for the next 7 days------------CORRECT
A 34 year old woman with a history of chronic hypertension attends the antenatal clinic at 34 weeks gestation. Her BP is 148/92 mmHg on labetalol 200 mg four times a day and there is no proteinuria. Fetal growth scan and umbilical artery Dopplers are normal. Delivery should be planned
A. After 37 weeks --------------------CORRECT
B. At 37 weeks
C. After a course of corticosteroids
D. Within the next 24-48 hours
E. At 40 weeks
A 40 year old woman with chronic hypertension attends the antenatal clinic at 14 weeks gestation. She has no other risk factors and there is no evidence of end-organ damage secondary to hypertension. Her BP is 132/65 mmHg on labetalol 200 mg four times a day and coracten 60 mg once a day. The plan for fetal monitoring should include
A. Computerised CTG weekly from 37 weeks
B. CTG weekly from 37 weeks
C. CTG only if there are other fetal concerns --------------------CORRECT
D. CTG daily if induction of labour declined at 37 weeks
E. CTG weekly if induction of labour declined at 37 weeks
A 40 year old woman with chronic hypertension attends the antenatal clinic at 14 weeks gestation. She has no other risk factors and there is no evidence of end-organ damage secondary to hypertension. Her BP is 132/65 mmHg on labetalol 200 mg four times a day and coracten 60 mg once a day. The plan for fetal monitoring should be
A. Umbilical artery Doppler at 23 weeks + growth scans at 28, 32, 34 and 36 weeks
B. Growth scan at 28-30, 32-34 and 36-38 weeks
C. Growth scan at 24-26, 28-30 and 32-34 weeks
D. Growth scan at 28-30 and 32-34 weeks
E. Uterine artery Doppler at 23 weeks + growth scan at 28-30 and 32-34 weeks-------------CORRECT
In pregnant women with chronic hypertension
A. Treatment of hypertension with methyldopa during pregnancy reduces the risk of pre-eclampsia
B. Treatment of hypertension with alpha-blockers during pregnancy reduces the risk of pre-eclampsia
C. Tight blood pressure control is associated with better maternal outcomes compared to less tight blood pressure control
D. Reduction of blood pressure with anti-hypertensive drugs is associated with a reduction in birth weight ---------------CORRECT
E. The target for blood pressure control should be higher for women with evidence of end-organ damage
A 32 year old woman with a history of chronic hypertension attends the antenatal clinic at 10 weeks gestation. Her BP = 142/88 mmHg and there is no proteinuria.
A. Aspirin from 12 weeks gestation
B. Aspirin from 12 weeks gestation + uterine artery Dopplers at 23 weeks-----------------CORRECT
C. Uterine artery Dopplers at 23 weeks + aspirin if bilateral notching
D. Baseline pre-eclampsia blood tests + aspirin from 10 weeks
E. Aspirin from 12 weeks and increase dose if uterine artery Dopplers abnormal at 23 weeks
With respect to the potential side-effects of anti-hypertensive drugs used during pregnancy and the post-natal period
A. Labetalol is associated with low placental weight
B. Atenolol is associated with low birth weight ----------------CORRECT
C. There is a recognized association between labetalol and neonatal hypoglycaemia
D. There is a recognized association between methyldopa and neonatal jaundice
E. ACE inhibitors can safely be used after the second trimester
A community midwife phones you about a 34 year old woman had a spontaneous vaginal delivery following induction of labour at 39 weeks gestation because of moderate gestational hypertension. She is on labetalol 200 mg 4 times a day. On day 15 post-partum, her BP is 146/88 mmHg.
A. Repeat BP weekly for 6 weeks
B. Repeat BP twice a week for 6 weeks
C. Refer to physician with interest inessential hypertension
D. Refer to day unit for medical review--------------CORRECT
E. Refer to obstetric medical clinic
A 34 year old woman has a spontaneous vaginal delivery following induction of labour at 39 weeks gestation because of moderate gestational hypertension. She is on labetalol 200 mg twice a day. On day 2 post-partum, you are asked to review her. Her BP has been 130-135/80-88 mmHg.
A. Stop anti-hypertensive drugs
B. Increase dose to 200 mg three times a day
C. Omit next dose of labetalol
D. Continue current treatment ---------------------CORRECT
E. Change labetalol to coracten
A 40 year old woman has labour induced at 39 weeks gestation because of mild gestational hypertension. She has a ventouse delivery and her post-natal BP is 145/95 mmHg. She is discharged 24h after birth and is not on any medication.
A. Monitor BP at least once between days 3 and 5 -------------------CORRECT
B. Monitor BP daily from days 3-5
C. Monitor BP daily from days 3-7
D. Monitor BP weekly for the next 2 weeks
E. Monitor BP weekly for the next 6 weeks
A low risk 33 year old woman attends the assessment unit at 36 weeks gestation. The woman’s BP is 155/98 mmHg and there is no proteinuria. She has no symptoms, feels good fetal movements and the fundal height is on the 50th centile on a customized growth chart. Blood tests, CTG and fetal growth scan are normal with normal umbilical artery Dopplers.
A. Deliver within 24-48h
B. Deliver once corticosteroids administered
C. Stabilize blood pressure and deliver
D. Deliver after 37 weeks if BP well controlled ---------------------CORRECT
E. Deliver at 37 weeks if BP well controlled
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