Home' Australian Pharmacist : Australian Pharmacist February 2016 Contents Australian Pharmacist February 2016 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
KEY LEARNING POINTS
Pre-eclampsia is a condition of
pregnancy that generally occurs after
20 weeks’ gestation and can also
Hypertension is an important
characteristic of pre-eclampsia,
however, women may present with
other warning signs and symptoms
Pregnant women should be made
aware of the need to seek immediate
advice from a healthcare professional
if they experience any potential
warning signs or symptoms of
Low-dose aspirin and calcium
supplementation are both
recommended for women at high risk
You explain to Janine that given the stage
of her pregnancy and the symptoms
she has described, it is important to seek
medical advice immediately. You briefly
describe how pre-eclampsia is a condition
that some women develop in pregnancy
after 20 weeks and sudden or persistent
headache can be a warning sign.
You then ask to take her blood pressure
to determine the degree of urgency in
her receiving medical assistance. Her
blood pressure reading is 150/95 mmHg.
You explain that this is a higher than
normal ready and because she is
pregnant, she needs to see her doctor
today. You call the local GP practice and
arrange an appointment for her that
Her husband visits you the following
week and explains that Janine had blood
tests and is seeing her obstetrician at
the hospital several times a week for her
condition to be monitored.
• Australian Action on Pre-eclampsia
(AAPEC). Visit: www.aapec.org.au
• Preeclampsia Foundation. Visit:
• Pharmacy Self Care Fact Card on high
1. 3centres Collaboration. Hypertension in Pregnancy,
Preeclampsia and Eclampsia Clinical Practice Guidelines
2010. At: http://3centres.com.au/library/uploads/guideline/
2. Royal Women’s Hospital. Pre-eclampsia: Management, 2014.
Clinical Guideline. At: https://thewomens.r.worldssl.net/
3. Explaining pre-eclampsia. Factsheet, 2012. At: https://
4. Royal College of Obstetricians and Gynaecologists. Pre-
eclampsia [Aug 2012]. At: www.rcog.org.uk/globalassets/
5. WHO recommendations for prevention and treatment of
pre-eclampsia and eclampsia. WHO. At: http://apps.who.
6. Steegers EAP, von Dadelszen P, Duvekot JJ, et al. Pre-
eclampsia. Lancet 2010; 376:631−44 .
7. Lim K-H. Preeclampsia [revised Dec 2014]. Medscape. At:
8. NICE guidance. The management of hypertensive disorders
during pregnancy (August 2010). At: www.nice.org.uk/
9. Uzan J, Carbonnel M, Piconne O, et al. Pre-eclampsia:
pathophysiology, diagnosis, and management. Vasc Health
Risk Manag 2011;7:467−74 .
10. Deering SH. Abruptio Placentae [revised Sep 2015].
12. Ross MG. Eclampsia [revised Sept 2014]. Medscape. At:
13. Knight M on behalf of UKOSS. Eclampsia in the United
Kingdom 2005. BJOG 2007;114:1072–8 .
14. Walker CK, Krakowiak P, Baker A, et al. Preeclampsia,
placental insufficiency, and autism spectrum disorder or
developmental delay. JAMA Pediatr 2015;169:154–62.
15. Lowe SA, Bowyer L, Lust K, et al. Guideline for the
management of hypertensive disorders of pregnancy.
Society of Obstetric Medicine of Australia and New
16. Royal Women’s Hospital. Magnesium sulphate:
Management of hypertensive disorders in pregnancy,
2015. Clinical Guideline. At: https://thewomens.r.worldssl.
17. Duley L. Pre-eclampsia, eclampsia, and hypertension. BMJ
Clin Evid 2011;2011:1402.
18. Hofmeyr GJ, Lawrie TA, Atallah ÁN, Duley L. Calcium
supplementation during pregnancy for preventing
hypertensive disorders and related problems. Cochrane
Database of Systematic Reviews. 2010;8(CD001059)
19. Constantine MM, Cleary K. Pravastatin for the prevention
of preeclampsia in high-risk pregnant women. Obstet
20. ClinicalTrials.gov. Pravastatin for prevention of
preeclampsia. At: https://clinicaltrials.gov/ct2/show/
21. Wen SW, Chen XK, Rodger M, et al. Folic acid
supplementation in early second trimester and the risk of
pre-eclampsia. Am J Obstet Gynecol 2008;198:45.e1-7.
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1. Choose the CORRECT statement
a) The presenting clinical features of pre-
eclampsia are usually obvious.
b) Pre-eclampsia is characterised by new-
onset hypertension with proteinuria.
c) The incidence of pre-eclampsia is higher
in subsequent pregnancies.
d) Pre-eclampsia usually develops after 28
2. Which of the following is a possible
warning sign or symptom of pre-
a) Visual disturbances.
b) Epigastric pain.
e) All of the above.
3. Risk factors for pre-eclampsia
a) Family history of pre-eclampsia, multiple
b) Maternal age <40 years, chronic
c) First pregnancy, low BMI (<18.5 kg/m2).
d) Short pregnancy interval, diabetes.
4. Choose the CORRECT statement
a) It only occurs in women with a history
b) There are always warning signs and
c) Eclamptic seizures can occur after
d) It affects approximately 1 in 10
5. In which of the following women
is low-dose aspirin (75 mg/day)
from 12 weeks of pregnancy MOST
a) Family history of pre-eclampsia and
b) Diabetes and twin pregnancy.
c) First pregnancy at age 42 years.
d) First pregnancy at age 16 years.
EVIDENCE IN PATIENT CARE
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