Simon Ash Profile picture
Passionate about #OBAnes and #patientsafety (#OBcritcare special interest). Father of 2 future Jedi. Views my own. he/his #heforshe 🇿🇦🇮🇪🇨🇦

May 19, 2023, 13 tweets

@AliciaTDennis starts day 2 of #OAA23ASM with an update on the management of preeclampsia. #OBAnes

The problem of preeclampsia and maternal morbidity & mortality is not new (1933 - 33.3% with eclampsia DIED) Nor is it a UK/ US problem. #OBAnes #OAA23ASM

Cardiac disease and preeclampsia feature as leading causes of maternal mortality in @mbrrace reports. Complications of preeclampsia are multiple. Preeclampsia and heart disease are included in key messaging. It’s a @WHO problem: international comparisons. #OBAnes #OAA23ASM

Health equity is very topical, and management of preeclampsia is no exception. Definitions. A multisystem disease with multiple threats. Important KEY MESSAGE: preeclampsia IS heart disease. #OBAnes #OAA23ASM

The first step is eliminating magical language. Know the hypertensive emergencies. Know the impact of hypertension in perioperative period. #OBAnes #OAA23ASM

Diagnostic aids are important - hypertension in pregnancy is potentially a continuum. Hypertension should be treated with antihypertensives. #OBAnes #OAA23ASM

Additional symptoms/signs - time for magnesium AS WELL. Magnesium has been in our armamentarium for long time. Do NOT use benzodiazepines as first line for seizure treatment. #OBAnes #OAA23ASM

#OBAnes goal is a safe birth. Neuraxial is preferred. Ablate hypertensive response of GA. Careful fluids. NO ergot. MONITOR. On neuraxials: 70 is the new 100 for platelets. #OAA23ASM

Regarding #OBAnes: preoperative, intraoperative and postoperative interventions. Ensure SBP>160mmHg is treated. Avoid ergometrine/ ergot. Allow as much time as possible (even in face of fetal distress, to avoid hypertensive effects of intubation during GA. Consider A-line.… twitter.com/i/web/status/1…

Dealing with diagnostic uncertainty. POCUS - echo (@AnaSjaus @KalagaraHari). Healthy pregnant patient views. TTE has a role to play. #OBAnes #OAA23ASM

Diagnostic tool for important differential diagnoses. #OBAnes #OAA23ASM

World Hyoertension Day was 17 May 2023. New recommendations to improve care. Critical hypertension no longer exists - manage as a continuum. #OBAnes #OAA23ASM

@threadreaderapp unroll please

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