6 - Obs - Other Medical Disorders in Pregnancy - Renal and Liver disease in pregnancy

Question 1

Intrahepatic Cholestasis of Pregnancy
? condition of preg characterized by ? without ?but ? LFTs. Due to abnormal sensitivity to ? effects of ?. Occurs in 0.7% preg women, familial, tends to recur ?%. Traditionally ass w incr risk of sudden ? and ? delivery. Risk of stillbirth (1%) prob due to ?
effects of ? salts, may precip fetal ?. Serum bile acids ?.

Answer 1

multifactorial
itching
rash
abnormal
cholestatic
oestrogens
50%
stillbirth
preterm
toxic 
bile
arrhythmias
raised

Question 2

Intrahepatic Cholestasis of Pregnancy
-Due to incr ? and ? tendency to ?, Vit K 10mg/d given from ?wks. ???? relieves itching and may reduce ? risk. ???
and ??? predict adverse outcomes poorly,
? at 38wks, may be compx. ?wk follow-up indicated to ensure ??? return to normal.

Answer 2

mat and fet
haemorrhage
36
UDCA
obstetric
CTG + USS
induce
6
LFTs

Question 3

Renal disease - In preg ? incr by 40% -> ? and creatinine levels ?

Answer 3

GFR
Urea
decrease

Question 4

Chronic renal disease
-preg not advised if creatinine >?mmol/l. Renal function often worsens ? in preg, more common in ?
disease, can be ?. Proteinuria -> diagnostic confusion w ? (more common but present wks

Answer 4

200
late
severe
permanent
preeclampsia
20

Question 5

Chronic renal disease-
Fetal compx inc pre-eclampsia, ????, ? and ?delivery. Mgmt: ??? for fetal growth, measurement of ?function, screening for ??? and control of ???. ? if severe.

Answer 5

IUGR
polyhydramnios
preterm
USS
Renal
UTI
HTN
Dialysis

Question 6

Urinary Infection
-Ass w ? labour, anaemia and incr ? morb and mort. Asymp ? in 5% women, in preg more likely to > ? (20%). Culture urine at ? and trt. Culture again if ? found on urinalysis. Pyelonephritis affects 1-2% women > ? pain, ?, vomiting and ?. ??abx. E coli = ?%, resistant to ?.

Answer 6

preterm
perinatal
bacteruria
pyelo
booking
nitrites
loin
rigors
fever
IV
75
amoxicillin