21: Medical Complications in Pregnancy

Question 1

screening for gestational DM

Answer 1

50gm glucose drink in one hour -> values 130+ are abnormal

Question 2

next step if pts gestational DM test is abnormal

Answer 2

3 hour 100gm oral glucose tolerance test

Question 3

maternal complications of gestational DM

Answer 3

gestational HTN, preeclampsia, DM later in life (70%)

Question 4

fetal complications of DM in pregnancy

Answer 4

birth defects**, SAB, IUGR, prematurity

Question 5

Class A1 and A2 gestational DM

Answer 5

A1: gestational DM, diet controlled
A2: gestational DM, insulin or oral meds controlled

Question 6

med options for DM in pregnancy

Answer 6

insulin -> metformin

Question 7

two meds that can be used for maternal hyperthyroidism

Answer 7

PTU, methimazole

Question 8

biggest risk of maternal hyperthyroidism meds

Answer 8

can cause fetal goiter -> cant deliver vaginally

Question 9

S/S thyroid storm

Answer 9

hyperthermia, tachy, perspiration, high output cardiac failure, maternal mortality of 25%

Question 10

untx hypothryoid in pregnancy

Answer 10

SAB, preeclampsia, abruption, low birth weight infants, stillbirth

Question 11

neonatal thyrotoxicosis

Answer 11

transplacental transfer of thyroid stimulating Abs (transient)

Question 12

primary pulmonary HTN and pregnancy

Answer 12

pregnancy contraindicated bc decompensation -> high mortality rate

Question 13

MC cardiac arrhtymia in pregnancy

Answer 13

SVT

Question 14

best thing for pregnant cardiac pts**

Answer 14

co-management with a cardiologist

Question 15

tx for immune idiopathic thrombocytopenia

Answer 15

prednisone

Question 16

fetal complications of SLE

Answer 16

preterm delivery, IUGR, miscarriage, neonatal lupus

Question 17

fetal complications of Anti-phospholipid syndrome

Answer 17

miscarriage, preeclampsia, IUGR

Question 18

what causes asymptomatic bacteriuria

Answer 18

urinary stasis, glucosuria -> E coli MC organism

Question 19

hyperemesis gravidaru

Answer 19

N/V persistent, >5% loss of pre-preg weight, ketonuria, dehydration

Question 20

Chron and UC in pregnancy

Answer 20

usually do pretty well, only issue is possible nutrition deficits

Question 21

ICP: intrahepatic cholestasis of pregnancy

Answer 21

cholestasis and pruritis in 2nd half of pregnancy - benign for mother but increased risk of fetal demise

Question 22

treatmet for ICP

Answer 22

ursodeoxycholid acid, cold baths, but nothing helps fetal state

Question 23

Acute fatty liver of pregnancy: cause and sx

Answer 23

cause unknown -> abd pain, N/V, jaundice, irritability, HTN

Question 24

acute fatty liver of pregnancy treatmet

Answer 24

termination of pregnancy bc maternal and fetal mortality are high

Question 25

MC cause of anemia during pregnancy

Answer 25

IDA

Question 26

two tx for DVT in pregnancy

Answer 26

heparin, low-molecular weight heparin (Lovenox)

Question 27

severe asthma effects on fetus

Answer 27

miscarriage, preeclampsia, IUGR, fetal demise, preterm delivery

Question 28

tx for tension HA in pregnancy

Answer 28

acetaminophen

Question 29

migraines in pregnancy

Answer 29

often improve