Q: Which of the following is more predictive of adverse neurological events in patients with preeclampsia/eclampsia? (select one)
A) Systolic Blood Pressure (SBP)
B) Diastolic Blood Pressure (DBP)
C) Mean Arterial Pressure (MAP)
Answer: A
An important study published in 2019 from California comprising of 54 preeclampsia pregnancy-related deaths recorded over 5 years, showed 33 attributed to strokes - where SBP was above 160 mm Hg in 96% of cases. DBP was 110 or higher in 65% of cases.
Headache was reported by 87% of women before the stroke. The objective of this question is to point out this clinical warning/sign as a "good-to-strong chance to alter outcome" in two-thirds of cases with prompt blood pressure control.
#ob-gyn
#cardiology
#neurology
Reference:
Judy AE, McCain CL, Lawton ES, et al. Systolic Hypertension, Preeclampsia-Related Mortality, and Stroke in California. Obstet Gynecol 2019.
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