Page 1 of 2: O & G - The GFR in the later half of pregnancy

decembermist · Credits: 41121 My Scrapbook

complicated by pre-eclampsia is

a) elevated 10%
b) elevated 50%
c) decreased 10%
d) decreased 50%
e) unchanged

bhavu · Credits: 9481 My Scrapbook

i am confused between c and d. ifbut 50% is too much shoul be c not sure. i am sure that in pre eclampsia gfr is decrease.

decembermist · Credits: 41121 My Scrapbook

ans given is d)

Normally GFR increases by 50%

bhavu · Credits: 9481 My Scrapbook

thanks mist

decembermist · Credits: 41121 My Scrapbook

In normal pregnancy, GFR was elevated by 40% throughout pregnancy and during the first week post partum, and fell to levels similar to those in non-pregnant women within 1 month.

The development of GFR in diabetic pregnant women and in women with gestational hypertension was similar to that recorded in normal pregnancy

In subjects with preeclampsia the rise in GFR observed in normal pregnancy was absent, and no change in GFR was recorded after delivery

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bhavu · Credits: 9481 My Scrapbook

IAMS notes syas that in pet oedema cuased decrease renal plasma flow this leads to decrease gfr. thats why i was going for 10%. pl can some one give any text book refrence yaar.

decembermist · Credits: 41121 My Scrapbook

I've no idea...Searched both Dutta N Mudhaliar
Didnt get the ans..

Got tht abstract whn I searched in the google...so posted

Nyone with Williams ...pls do check

bhavu · Credits: 9481 My Scrapbook

ok i will try to find out .

pratik · Credits: 11374 My Scrapbook

hey check this out. it says 25 percent decrease than normal pregnancy

Systemic Effects

Cardiovascular
– Increased and labile blood pressure
– Decreased colloid oncotic pressure
– Intravascular volume depletion
– Systemic vasoconstriction
– Congestive heart failure

Hematologic
– Thrombocytopenia occurs in 15-30% of women with preeclampsia, platelet count < 100K in 10%
– Hypercoagulable, increased risk for thromboembolic disease
– Coagulopathy, activation of fibrinolysis
– Disseminated intravascular coagulation

Renal
– GFR averages 25% less than normal parturient
– Proteinurea secondary to increased vascular permeability
– Hyperuricemia
– Oliguria defined as < 400ml over 24 hrs
– Rarely creatinine changes
– Acute tubular necrosis

Pulmonary
– High risk of upper airway narrowing from pharyngolaryngeal edema
– Pulmonary edema (noncardiogenic>cardiogenic)

Hepatic
– Transaminases frequently elevated even in mild preeclamptics
– Epigastric/Subcostal pain (distension of liver capsule by edema or subcapsular bleeding)
– Coagulopathy (high INR)
– Decreased drug metabolism

Neurologic
– Headache
– Visual disturbances (scotomata)
– Hyperreflexia
– Intracranial hemorrhage
– Seizures: ? hypertensive encephalopathy, vasospasm, microemboli, cerebral edema, thromboses, punctate hemorrhages

Uteroplacental
– Decreased uteroplacental perfusion
– IUGR/ olighydramnios
– Placental abruption
– Preterm labor and delivery

bhavu · Credits: 9481 My Scrapbook

if this is so.what to choose between 10% and 50%

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