6 - Obs - Other Medical Disorders in Pregnancy - Cardiac Disease in pregnancy + Resp

Question 1

in preg - 40% incr in ?? due to incr ?? and ?? - and 40% incr in Blood ?
also 1/2 the systemic ? ?
-incr BF produces an ? ? murmur in 90%
-ECG altered: ? ? shift and ? T waves common

Answer 1

cardiac output
HR and SV
volume
vascular resistance
ejection systolic
left axis
inverted

Question 2

acquired/uncorrected ? cardiac disease = major cause of ? ?, usually due to ??
Incr CO acts as ? test, may not cope.
-usually manifests at ? weeks or in ? - blood loss/fluid overload -> ? cardiac failure

Answer 2

congen
mat mort
HF
exercise
28
labour
decompensated

Question 3

MGMT principles - signif disease pts assessed before ?
2 CI’s drugs?
-when to avoid preg?
-what Ix needed if cardiac disease?
-must treat ? - ?? normally used
-thromboprophylaxis continued with ????
-reg checks for ?
-in labour, monitor ??, an epidural reduces ?
-what helps avoid additional stress of pushing
-ABx in labour for some to protect against ?

Answer 3

pregnancy
ACEis and Warfarin
if severe decomp disease
echo
HTN  - BB's
LMWH
anaemia
Fluid balance
afterload
elective forceps
endocarditis

Question 4

Mild abnorms eg ? ? prolapse, PDA, VSD, ASD don’t usually lead to ?

Pulm HTN - eg ? syndrome, high maternal ? so preg is ?

Aortic stenosis - severe disease -> ? to incr CO, so correct this pre ? - with this an ? is CI’d. - ? for replaced AV’s

Answer 4

mitral valve
complx

eisenmengers
mort
CI’d

inability
preg
epidural
thromboprophylaxis

Question 5

Mitral Valve Disease:
Treat ?-?: In rare cases of stenosis, ?? may dev in late preg, B-blockade used. ? mitral valves v prone to ? and warfarin used after first ?wks, despite ? risks.
MI: Unusual, mort greater at ?gestations.
? Cardiomyopathy: Rare (1/3000) cause of HF, specific to preg. Dev in ?month or first ?m after preg w no recognizable cause. 15% risk of ? death, >50% leads to permanent ?? dysfunction. Trt supportive, ? and ?. Signif ?
rate.

Answer 5

pre-preg
HF
artificial
12
fetal
later
peripartum
last
6
maternal
LV
diuretics
ACEis
recurrence

Question 6

Tidal volume incr by ?%, no change in ?.
? common in preg. Preg has variable effect on disease: drugs shouldn’t be ? as they’re safe and ? asthma attack is potentially ? to mother and fetus. Well-controlled asthma has ? effect on outcome. Women on long-term ? req incr dose in ? due to chronically suppressed ?? not being able to prod adequate ? for stress of ?.

Answer 6

40
RR
asthma
withheld
severe
lethal
little
steroids
labour
adrenal cortex
steroids
labour