antenatal care

Question 1

management of pregnant women with previous history of VTE

Answer 1

low molecular weight heparin throughout antenatal period

Question 2

risk factors for VTE in pregnancy

Answer 2

Age > 35
Body mass index > 30
Parity > 3
Smoker
Gross varicose veins
Current pre-eclampsia
Immobility
Family history of unprovoked VTE
Low risk thrombophilia
Multiple pregnancy
IVF pregnancy

Question 3

criteria for treating for potential VTE

Answer 3

4 or more risk factors= immediate low molecular weight heparin until 6 weeks postnatal

3 risk factors= low molecular weight heparin from 28 weeks till 6 weeks postnatal

Question 4

features of obstetric cholestasis

Answer 4

pruritus
jaundice
raised bilirubin

Question 5

management of obstructive cholestasis

Answer 5

induction of labour at 37-38 weeks
ursodeoxycholic acid
vit k supplementation

Question 6

what is acute fatty liver of pregnancy

Answer 6

rapid accumulation of fat within the liver cells causing acute hepatitis

Question 7

features of acute fatty liver of pregnancy

Answer 7

abdominal pain
nausea and vomiting
headache
jaundice
hypoglycaemia
may cause pre-eclampsia

Question 8

investigations for acute fatty liver of pregnancy

Answer 8

ALT elevated
but also: raised bilirubin, raised WBC, deranged clotting, low platelets

Question 9

management of acute fatty liver of pregnancy

Answer 9

stabilise patient and deliver baby

Question 10

features of HELLP

Answer 10

nausea and vomiting
RUQ pain
lethargy

Question 11

treatment of HELLP

Answer 11

delivery of the baby