21: Medical Complications in Pregnancy Flashcards
screening for gestational DM
50gm glucose drink in one hour -> values 130+ are abnormal
next step if pts gestational DM test is abnormal
3 hour 100gm oral glucose tolerance test
maternal complications of gestational DM
gestational HTN, preeclampsia, DM later in life (70%)
fetal complications of DM in pregnancy
birth defects**, SAB, IUGR, prematurity
Class A1 and A2 gestational DM
A1: gestational DM, diet controlled
A2: gestational DM, insulin or oral meds controlled
med options for DM in pregnancy
insulin -> metformin
two meds that can be used for maternal hyperthyroidism
PTU, methimazole
biggest risk of maternal hyperthyroidism meds
can cause fetal goiter -> cant deliver vaginally
S/S thyroid storm
hyperthermia, tachy, perspiration, high output cardiac failure, maternal mortality of 25%
untx hypothryoid in pregnancy
SAB, preeclampsia, abruption, low birth weight infants, stillbirth
neonatal thyrotoxicosis
transplacental transfer of thyroid stimulating Abs (transient)
primary pulmonary HTN and pregnancy
pregnancy contraindicated bc decompensation -> high mortality rate
MC cardiac arrhtymia in pregnancy
SVT
best thing for pregnant cardiac pts**
co-management with a cardiologist
tx for immune idiopathic thrombocytopenia
prednisone
fetal complications of SLE
preterm delivery, IUGR, miscarriage, neonatal lupus
fetal complications of Anti-phospholipid syndrome
miscarriage, preeclampsia, IUGR
what causes asymptomatic bacteriuria
urinary stasis, glucosuria -> E coli MC organism
hyperemesis gravidaru
N/V persistent, >5% loss of pre-preg weight, ketonuria, dehydration
Chron and UC in pregnancy
usually do pretty well, only issue is possible nutrition deficits
ICP: intrahepatic cholestasis of pregnancy
cholestasis and pruritis in 2nd half of pregnancy - benign for mother but increased risk of fetal demise
treatmet for ICP
ursodeoxycholid acid, cold baths, but nothing helps fetal state
Acute fatty liver of pregnancy: cause and sx
cause unknown -> abd pain, N/V, jaundice, irritability, HTN
acute fatty liver of pregnancy treatmet
termination of pregnancy bc maternal and fetal mortality are high
MC cause of anemia during pregnancy
IDA
two tx for DVT in pregnancy
heparin, low-molecular weight heparin (Lovenox)
severe asthma effects on fetus
miscarriage, preeclampsia, IUGR, fetal demise, preterm delivery
tx for tension HA in pregnancy
acetaminophen
migraines in pregnancy
often improve
