Ante/PeriNatology (OB/MFM vibes)

Question 1

4 mechanisms of placental drug transfer and some examples of each?

(December 2021)

Answer 1

-simple diffusion: most drugs, small, lipophilic
-facilitate diffusion: Glucocorticoids ie BMZ, cephalosporins
-active transport
-pinocytosis

Question 2

Antenatal steroids
-effect between 24-34 weeks?
-effect after 34 weeks?

(January 2022)

Answer 2

-decreased risk of IVH and RDS, reduces perinatal mortality. Recommended in this time range if at high risk for delivery within 7 days

-controversial. But decreases need for respiratory support in first 3 days of life but not in the rate of NICU admit. A/w increased risk of neonatal hypoglycemia and unknown effects on long-term neurodevelopment

Question 3

Think of a newly delivered baby in the DR at 25 weeks gestation. What are examples of these different types of heat loss for this baby or strategies we use to reduce these types of heat loss?

-conductive
-radiant
-convective
-evaporative

(May 2022)

Answer 3

-heat lost from direct contact with any surfaces. So use of warmed blankets and thermal mattress help with this

-loss between neonate and any cooler surface in the environment via electromagnetic waves ie the ambient temperature of the room not being 74-77F

-in the DR, convective heat loss occurs from air drafts around the patient like with multiple providers entering and exiting for a maternal resuscitation

-evaporative heat loss is a major sources of hypothermia in preterm neonates and is avoided in DR with occlusive bag AND hat and in the NICU with humidified incubators

Question 4

Aspirin treatment and pre-eclampsia

(June 2022)

Answer 4

Low-dose aspirin treatment, preferably before 16 weeks’ gestation, is effective in preventing or delaying the onset of preeclampsia in women at high risk