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Oral Medicine and Diagnosis > Caring for the Pregnant Patient > Flashcards

Caring for the Pregnant Patient Flashcards

1
Q

what are the endocrine changes in pregnancy

A

multiple hormone changes

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2
Q

what are the cardivascular changes in pregnancy

A

increase of 20-40% in CO, tachycardia and flow murmurs

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3
Q

what are the hematologic changes in pregnancy

A

increase of 30% in maternal blood volume

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4
Q

what are the respiratory changes during pregnancy

A

increased rate of respiration

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5
Q

what is early term

A

37-38 weeks and 6 days

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6
Q

what is full term

A

39-40 weeks and 6 days

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7
Q

what is late term

A

41 weeks-41 weeks and 6 days

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8
Q

what is post term

A

42 weeks and after

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9
Q

what are the complications in pregnancy

A
  • spontaneous abortions
  • ectopic pregnancy
  • eclampsia
  • anemia
  • cardiovascular disease
  • oral
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10
Q

what is the probability of spontaneous abortions and why

A

15% during the first trimester and possible relationship to stress or bacteremia

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11
Q

what is ectopic pregnancy

A

fertilization and implantation of the fetus in a fallopian tube, resulting in abdominal pain and heavy bleeding

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12
Q

what is pre eclampsia marked by

A

hypertensino and proteinuria

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13
Q

what is eclampsia marked by

A

malignant hypertension, seizures, and encephalopathy

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14
Q

what is eclampsia

A

a condition in which high blood pressure and proteinuria lead to encephalopathy, coma, miscarriage and death

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15
Q

hormonal changes can either cause:

A

hypertension or syncope

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16
Q

hypertension is monitored to screen for ____

A

eclampsia

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17
Q

since syncope can lead to traumatic injury, prodromal symptoms should be addressed by:

A

assuming a prone position

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18
Q

what is anemia in pregnancy caused by

A

due to increased hematologic demands

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19
Q

what is cardiovascular disease in pregnancy caused by

A

exacerbation of underlying disease in response to increased demand

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20
Q

what are the oral complications in pregnancy

A

exacerbation of underlying periodontal disease

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21
Q

pregnancy gingivitis and exacerbated periodontitis exacerbated by:

A
  • lack of attention to oral hygiene
  • increased systemic fluid levels and capillary fragility from increased progesterone and estrogen
  • increased anaerobic bacterial plaque counts
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22
Q

what lesion is common in pregnancy

A

granulomatous reaction with a vascular component
- pyogenic granuloma
- epulis gravidarum
-pregnancy tumor

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23
Q

describe the pyogenic granuloma

A
  • not an actual granuloma as there is proliferation of vascular tissues as well as proliferation of fibrous tissue
  • forms submucosally and takes the shape of a nodular growth
  • though to be exacerbated response to plaque and bacteria precipitated by the changes in hormonal levels
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24
Q

what is the treatment for pyogenic granuloma

A
  • variable
  • conservative management is an option
  • may resolve post partum
  • gently curettage with electrocautery
    -excision to the periosteum and removal of calculus and plaque
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25
what are the general dental guidelines during pregnancy and in each trimester
- take a history of the trimester and note complications and BP - first trimester: fetus is especially susceptible to teratogenic influence and abortion - second trimester: optimal trimester for dental care - third trimester: syncope and hypertension risk are greatest secondary to fetal position. cardiovascular demands are greatest, there is increased risk of anemia, the highest risk of eclampsia, and increased risk of hypertension
26
when should preventative prophylaxis be done
at the beginning of the second trimester and the third trimester
27
all elective dental care should be:
deferred
28
when should nondeferrable treatment be completed and what is an example of this tx
- during second trimester - caries control
29
there is no risk of fetal death, malformation, growth retardation or impairment of mental facility at what mGy
0-50 mGy
30
what is the fetal dose for OMR imaging
0.01mGy
31
an absorbed dose to the conceptus of ____ doubles the natural childhood cancer rate from 1 in 500 to 1 in 250
25mGy
32
absorbed dose of _____ increases the childhood cancer rate to 1 in 375
12mGy
33
what is the effective dose for the fetus for single intraoral F-speed rectangular radiographs
1.3 micro Sv
34
what is the effective dose for the fetus for 4 BW F- speed recetangular radiographs
5 micro Sv
35
what is the effective dose for the fetus for FMX 20 F-speed rectangular radiographs
35 micro Sv
36
what is the effective dose for the fetus for FMS 20 F-speed round radiographs
171 micro Sv
37
what is the effective dose for the fetus for FMS 20 D-speed roundradiographs
388 micro SV
38
what is the effective dose for the fetus for pano radiographs
9-26 micro Sv
39
what is the effective dose for the fetus for CBCT
20-599 micro Sv
40
what is the recommendation for radiographs for pregnant pts
contraindicated in all but emergency situations. when taken lead shielding is necessary
41
what is the protocol for new and recall pregnant dental patients
- radiographs should be postponed until post partum - long term benefit to the health of the mother from new patient or recall exam radiographs - BUT no benefit to the health of a developing child - unborn child faces greater risks from the radiation exposure than the mother without any benefit to their health
42
what does the national council on radiation protection and measureemnts recommend
different radiation exposure thresholds for pregnant radiation workers than non pregnant radiation workers - radiation exposure thresholds for pregnant radiation workers is lowered to the same thresholds as the general population
43
what is the SoD recommendation for guidelines for pregnant patients
same as NCRP recommendations
44
what is the patient shielding protocol during dentomaxillofacial radiology
- discontinuing shielding of the gonads, pelvic structures, and fetuses during all dentomaxillofacial radiographic imaging procedures - thyroid shielding not be used during intraoral, panoramic, cephalometric and CBCT imaging as the risks of thyroid cancer are negligible from comtemporary maxillofacial imaging radiation doses
45
what is the radiograph protocol for emergency dental patients
- necessary radiographs are part of the standard of care to treat and dx a condition that threatens the health of the mother and the unborn child - lack of radiographs compromises the emergency care dx and tx, this will directly impact the health of the unborn child - primary beam is not directed toward the child bearing area
46
what are the protocols for medication
- there should be medical clearance for all drugs including LA, analgesics, and ABs - lidocaine, penicillin, erythromycin, and acetominophen are generally approved - aspirin and vasoconstrictors in LA and all drugs causing respiratory depression are relatively contraindicated - diazepam, nitrous, and tetracyline are absolutely contraindicated
47
is acetominophen safe during pregnancy
yes
48
is aspirin safe during pregnancy
avoid
49
is codeine safe during pregnancy
use with caution
50
is glucocorticoids safe during pregnancy
avoid
51
is hydrocodone safe during pregnancy
use with caution
52
is IBU safe during pregnancy
avoid use in third trimester
53
is oxycodone safe during pregnancy
use with caution
54
what meds should you avoid in the first and third trimester
-aspirin - IBU - naproxen
55
is clarithromycin safe during pregnancy
use with caution
56
is doxycycline safe during pregnancy
avoid
57
is tetracycline safe during pregnancy
no
58
what antibiotics are safe during pregnancy
- amoxicillin - cephalosporins - clindamycin - metronidazole - penicillin
59
what medications should be avoided during pregnancy
- ciprofloxacin - clarithromycin - levofloxacin - moxifloxacin
60
what med do you never use in pregnancy
tetracycline
61
what antimicrobials can be used during pregnancy
- cetylpyridinium chloride mouth rinse - chlorhexidine mouth rinse - xylitol
62
what anaesthetics can be used for pregnancy
- lidocaine with or without epi - prilocaine - dyclonine (topical) - lidocaine (topical)
63
lidocaine has no evidence of harm at _____ times the max recommended human dose
6.6
64
prilocaine has no evidence of harm at _____ times the max recommended human dose
30
65
what are the considerations for NO with pregnant patients
pregnant women require lower levels of NO to achieve sedation, consult with prenatal care health professional
66
what is gestational diabeters
high blood sugar affecting pregnant women who have insufficient insulin production relative to metabolic needs - some instances may be insulin resistance
67
gestation diabetics are at higher risk of:
developing type 2 diabetes later in life
68
what are the symptoms of gestational diabetes
generally asymptomatic
69
when does gestational diabetes present
24-28 weeks
70
what is the tx for gestational diabetes
- daily blood sugar monitoring - special meal plans emphasizing a healthy diet - exercise - monitoring the baby - daily blood glucose testing and insulin injections - if the above considerations are not responsive and blood sugar remains high, medication is needed such as IM insulin or metformin PO
71
which medication is preferred for gestational diabetes if you have to give meds
metformin
72

Oral Medicine and Diagnosis (12 decks)

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