9: Antenatal Pharmacology

Question 1

uterine tachysystole

Answer 1

5+ contractions in 10 minutes

Question 2

explain an epidural

Answer 2

large bore needle into L2-3 / L3-4 / L4-5 space -> catheter in epidural space -> continuous infusion of anesthetic agents

Question 3

explain amnion and prostaglandins

Answer 3

1. PGDH: from chorion, inactivates prostaglandins, is active during pregnancy
2. Amnion produces prostaglandins throughout pregnancy, mostly inactivated by PGDH
3. late pregnancy/labor: decreased PGDH -> prostaglandins can function -> membrane rupture and uterine contractility

Question 4

RDS affects 40-50% of babies born before week __.

Answer 4

32

Question 5

why cant you give cortisol to prevent RDS?

Answer 5

placenta inactivates it (so you can give it to mother as needed for her own health issues)

Question 6

two factors that help the ductus arteriosus close a few days after birth

Answer 6

increased oxygen tension, decreased PGE2

Question 7

sx of clinically-significant patent ductus arteriosus

Answer 7

murmur, poor eating, sweating with crying or eating, fast breathing, easy tiring, rapid HR

Question 8

five HTN drugs that can be used in pregnancy

Answer 8

a-methylopa, laetalol, hydralazine, sodium nitroprusside, nifedipine

Question 9

two drugs that can never be used for HTN in pregnancy bc cause fetal death

Answer 9

ACEI and ARBs