Ch Ch 10 Flashcards
The most common cyanotic congenital heart disease in pregnancy is
tetralogy of Fallot.
Signs of heart disease include the following
• Any diastolic or continuous heart murmur
• Any systolic murmur associated with a thrill • Any severe arrhythmias
• Unequivocal cardiac enlargement
Corrected Tetralogy of Fallot (TOF) refers to a patient who has undergone surgical repair for Tetralogy of Fallot, a congenital heart defect that includes four anatomical abnormalities:
- Pulmonary stenosis (narrowing of the pulmonary valve or artery),
- Ventricular septal defect (VSD) (a hole between the right and left ventricles),
- Overriding aorta (the aorta is positioned directly above the VSD),
- Right ventricular hypertrophy (thickening of the right ventricular muscle).
Eisenmenger syndrome is characterized by
pulmonary hypertension and a bidirectional intra-cardiac shunt
symptoms present at rest, increasing with any physical activity
Class IV
no symptoms at rest, but marked limitations with activity
Class III
no symptoms at rest, but minor limitations with activity
Class II
Fetal thyroid function begins as early as ——— with minimal transfer of T3 or T4 across the placent
12 weeks
Management of Antepartum cardiac disease
Left lateral rest, 2 g sodium diet, digitalis as indicated, diuretics as indicated, avoid strenuous activity, avoid anemia, fetal echocardiogram (if patient has congenital heart disease).
The underlying etiology of hyperthyroidism may be
Graves’ disease,
toxic nodular goiter ( Plummer’s disease),
hydatidiform mole
toxic diffuse goite
Thyroid storm
is a life-threatening hypermetabolic state presenting with pyrexia, tachycardia, and severe dehydration.
Management of thyroid strong is
propylthiouracil (PTU), β-blocking agents, steroids, and iodine.
(most common kind of hyperthyroidism in pregnancy)
Graves disease
TSHR-Ab can cross the placenta, potentially causing fetal hyperthyroidism. In
Graves’ disease
Diagnosis of Graves disease is
confirmed by elevated free T4 and TSHR-Ab, as well as low TSH in the presence of clinical features described above
Management of Graves’ disease
- Antithyroid medications are the first line of therapy in pregnancy, but they can cross the placentae leading to fetal hypothyroidism.
- PTU and methimazole are thioamides that block thyroid hormone synthesis.
- Subtotal thyroidectomy is primarily indicated when antithy- roid medical therapy fails and is ideally performed in the second trimeste
are the first line of therapy in pregnancy, but they can cross the placentae leading to fetal hypothyroidism.
Anti thyroid medication
is contraindicated in pregnancy because it can cross the placentae, destroying the fetal thyroid
Thyroid ablation with radioactive iodine (I131)
is most commonly a primary thyroid defect and often results in an ovulation and infertility
Hypothyroidism
Hypothyroidism is associated with
Increase level of TSH
Decrease level of free T4
An ovulation
Management of hypothyroidism in pregnancy
Increase supplemental thyroid hormone by 30% in pregnancy
إذا تمت معالجة مشكلة الغدة الدرقية في الحمل فان النتيجة هي
Normal pregnancy
How we can treat hyperthyroidism in pregnancy
- Polythyrouracil PTU in first trimester
- methimazole in 2ed @ 3ed trimester
How we treat Hypothyroidism in pregnancy
Synthroid طبعا مع ريادة الجرعة بنسبة ٣٠٪ عن السيدة العادية
How we treat Hypothyroidism in pregnancy
Synthroid طبعا مع ريادة الجرعة بنسبة ٣٠٪ عن السيدة العادية
The most common risk factors for gestational diabetes are
obesity,
age >30,
positive family history.
Other risk factors are fetal macrosomia, unexplained stillbirth or neonatal death, poly- hydramnios, and previous traumatic delivery.
Prevalence of glucose intolerance in pregnancy is
2–3%.
………… is the most common anemia in women because of pregnancy and menstrual needs
Iron deficiency anemia
………… is the most common anemia in women because of pregnancy and menstrual needs
Iron deficiency anemia
Hypersegmantal neutrophil
Folate anemia
are peripheral blood tests used to detect the presence or absence of haemoglobin s
Screening tests
