8/19/13 Lecture Flashcards
Until what week can you travel on an airplane while pregnant?
Week 36
What is one of our biggest teratogens?
too much glucose
If there is placenta previa at 24 weeks what should you do?
Get an US a little later to make sure the placenta has moved
What does breast feeding help with?
Involution of the uterus
passive immunity
weight loss for mom
bonding
How much exercise can pregnant women do?
About 30 minutes a day;
No supine or extreme weight lifting
What are some absolute contraindications for exercise in pregnant women?
lung dz severe heart dz incompetent cervix multi-fetal gestation vaginal bleeding placenta previa preterm labor, ROM HTN disease of IUP
What are the crucial weeks for organogenesis?
weeks 5-9
what should fetal exposure to ionizing radiation be limited to?
< 5 rads accumulation
In the 1st 2 weeks after fertilization when do major effects of ionizing radiation occur?
> 10 rads
In the 1 trimester when will there be major effects of ionizing radiation?
> 25 rads
In the 2nd and 3rd trimester fetal exposure above what has major effects?
> 100 rads
12 oz of what type fish are good for pregnant women (per week)?
shrimp light tuna salmon pollock catfish
6 oz of what type fish are good for pregnant women (per week)?
albacore tuna
What does fetal alcohol syndrome look like?
IUGR stunted growth post birth low set ears mild-facial hypoplasia microcephaly mental retardation
What are some things that are teratogens (herbal)?
Echinacea black cohosh (estrogenic) garlic (supplements) (anti coag) willow bark (anti coag) gingko (anti coag) licorice (HTN) blue cohosh (UC's)
What category is okay for pregnant women?
Category A
What category is contraindicated (only use if risk outweighs benefit)?
Category X
What category is where animal studies ahve shown fetal harm and no adequate studies/ pregnant women or there are no animal studies or well conducted studies in pregnant women (can’t rule out risk)
Category C
What is the category for aminoglycosides (streptomycin, gentamycin)?
Category X
Can warfarin be used in pregnant women?
No (especially in weeks 6-9)
Can lithium be used in pregnant women?
No
What HTN drugs can’t be used in pregnancy?
ACEIs and ARBs
What neuroleptics shouldn’t be used in pregnancy?
valproic acid
carbamazepine
phenytoin
Can retinoids be used during pregnancy?
No; women must be on two forms of birth control while they are on it
If a pregnant women has GERD what should you use?
Antacids and dietary modifications
restrict before bedtime
Use H-2 blockers
What are some H-2 blockers that can be used in pregnancy?
Ranitidine
Famotidine
PPI: omperazole (C)
What can a pregnant women do for constipation?
Fluids, fiber
avoid aluminum based antacids
Metamucil
Stool softener= docusate (Colace)
What should pregnant women avoid for constipation?
Castor oil
milk of magnesia
What can pregnant women do with hemorrhoids?
Avoid constipation Sitz bath (sit in warm water) Tucks pads (witch hazel) Preparation H Anusol suppositories (zinc) rubber band ligation (extremes)
What should you use for 1st line therapy in T2DM pregnant women?
Insulin or oral (glyburide (C, but doesn’t cross placenta), metformin (B) )
How do you treat GDM?
Diet and weight control
Is it better to use glyburide or metformin for T2DM?
Glyburide (C) because it doesn’t cross the placenta
What meds can you use for HTN pregnancy women?
Beta blockers: labetalol, propranolol, hydralazine, nifedipine
What is 1st line therapy for pregnant women with thromboembolic events?
Heparin (doesn’t cross placenta)
What meds can be used in pregnant women for asymptomatic bacteriuria or UTI?
Penicillins
Cephalosporins
Nitrofuratoin
what antibiotics should be avoided in pregnant women?
TCN (tetracycline- bad teeth)
fluoroquinolones
trimethoprim (folate antagonist)
sulfamethoxazole (last trimester- hyperbilirubemia)
What can be used in pregnant women for asthma?
Inhaled cromolyn
Inhaled steroid: budesonide (B),
Albuterol (C)- severe
Oral corticosteroids shouldn’t be withheld
What can be used for acne treatment in pregnant women?
Erythromycin, clindamycin, benzoyl peroxide (C)
Pregnant women who use SSRIs (paroxetine) have babies at increased risk for what?
Ventral and atrial septal defects
neonatal behavior syndrome for all SSRIs
What is the 1st line therapy for migraines in pregnant women?
Acetaminophen
Do migraines generally improve with pregnancy?
Yes (can get worse in first trimester though)
