Conditions in Pregnancy

Question 1

What is Gestational Diabetes?

Answer 1

Glucose intolerance recognized during pregnancy

Question 2

When do you screen for Gestational Diabetes?

Answer 2

24-28 weeks

Question 3

When screening for Gestational Diabetes, the 50gm oral 1 hour glucose is given. Above what number is abnormal?

Answer 3

> 130

Question 4

Once the 50gm oral 1 hour glucose is given, if it comes back abnormal, what is then given in order to confirm Gestational Diabetes?

Answer 4

100gm oral 3 hour glucose

Question 5

With Gestational Diabetes, what is the mother at a very increased risk for?

Answer 5

Developing Diabetes later in life

Question 6

List some fetal complications with Gestational Diabetes? (5)

Answer 6

Macrosomia
Shoulder Dystocia
Still birth
Hypoglycemia
Hyperbilirubinemia

Question 7

If a neonate has hypoglycemia, his mother probably had?

Answer 7

Gestational Diabetes

Question 8

With Gestational Diabetes, what is the intrapartum management if the patient has a controlled diet/glucose?

Answer 8

Glucose testing

Question 9

With Gestational Diabetes, what is the intrapartum management if the patient is on meds?

Answer 9

Insulin drip

Hourly glucose testing

Question 10

What neonate outcome is linked to an increased glycosylated hemoglobin level of the mother?

Answer 10

Birth defects

Question 11

With Gestational Diabetes, the insulin requirements will ____ postpartum

Answer 11

DECREASE

Question 12

What levels of TSH and T4 define Hyperthyroidism?

Answer 12

LOW TSH

HIGH T4

Question 13

With Maternal Hyperthyroidism, when is Proplythiouracil given?

Answer 13

1st trimester

Question 14

With Maternal Hyperthyroidism, when is Methimazole given?

Answer 14

2nd and 3rd trimesters

Question 15

When the mother is taking medications for her Hyperthyroidism, what can the meds do?

Answer 15

Cross the placenta

• -> Fetal hypothyroidism
• -> Fetal Goiter maybe

Question 16

What can trigger a Thyroid Storm?

Answer 16

Medication noncompliance

Infection, labor, C-section

Question 17

What are the signs of a Thyroid Storm?

Answer 17

Hyperthermia, sweating
Increased HR
High output cardiac failure

Question 18

If a mother with Hyperthyroidism presents with hyperthermia, sweating, an increased HR and high output cardiac failure, what is likely?

Answer 18

Thyroid Storm

Question 19

What is Neonatal Thyrotoxicosis?

Answer 19

Thyroid stimulating antibodies cross the placenta

– usually transient effects

Question 20

Neonatal Hypothyroidism causes?

Answer 20

Developmental retardation

Question 21

What cardiac disease is a CONTRAINDICATION to pregnancy due to decompensation?

Answer 21

Primary Pulmonary HTN

Question 22

Describe what happens with Postpartum Cardiomyopathy?

Answer 22

• No previous underlying cardiac disease
• -> Cardiomyopathy develops at the end/after pregnancy
• -> 10% fatal

Question 23

If a mother has no underlying heart disease but suddenly develops issues after the delivery of her baby, what is it?

Answer 23

Postpartum Cardiomyopathy

Question 24

ALL pregnant cardiac patients must be co-managed with?

Answer 24

Cardiologist

Question 25

(+) lupus anticoagulant | (+) anticardiolipin antibody

Answer 25

Antiphospholipid Syndrome

Question 26

If a patient has a history of thrombosis, they need full anticoagulation. What immune condition causes issues with pregnancy due to thrombosis?

Answer 26

Antiphospholipid Syndrome

Question 27

Renal Disease in pregnant patients =

Answer 27

BAD

Question 28

What pathogen causes Asymptomatic Bacteriuria and what 2 infections can develop?

Answer 28

E.Coli | --> Cystitis and Pyelonephritis

Question 29

What are the symptoms of Pyelonephritis?

Answer 29

Fever | CVA tenderness

Question 30

What 2 lab results will be present with Pyelonephritis?

Answer 30

Increased WBC | Abnormal Urinalysis

Question 31

Mothers with Pyelonephritis will likely have what 2 things occur?

Answer 31

Preterm labor | Adult RDS

Question 32

What is the treatment for Pyelonephritis in a pregnant woman?

Answer 32

Suppression for the REST OF PREGNANCY

Question 33

What is Hyperemesis Gravidarum?

Answer 33

Persistent N/V with weight loss, ketonuria and dehydration

Question 34

With persistent N/V that causes more than 5% of pre-pregnancy weight loss, what is the treatment if severe?

Answer 34

(hyperemesis gravidarum) | = Nasogastric feeding or parenteral nutrition

Question 35

Mendelson's Syndrome

Answer 35

Acid Aspiration

Question 36

Treatment for Tension Headaches?

Answer 36

Acetaminophen

Question 37

During pregnancy, the woman is at a hyper-coagulable state. When is she at the greatest risk for DVT/PE?

Answer 37

First 5 weeks after delivery

Question 38

What is Intrahepatic Cholestasis of Pregnancy?

Answer 38

Cholestasis and Pruritus in the second half of the pregnancy

Question 39

What is the main symptom with Intrahepatic Cholestasis of Pregnancy?

Answer 39

ITCHING | -- no rash present

Question 40

Does Intrahepatic Cholestasis of Pregnancy recur?

Answer 40

YES | -- recurs with each pregnancy usually

Question 41

What is the fetus at risk of if the mother has Intrahepatic Cholestasis of Pregnancy?

Answer 41

Increased bile acids in mother | --> FETAL DEMISE (and meconium stained amniotic fluid)

Question 42

A pregnant woman presents with itching all over, no rash and increased bile acids. What is her diagnosis? What is the fetus at risk of?

Answer 42

Intrahepatic Cholestasis of Pregnancy | Fetal demise and meconium stained amniotic fluid

Question 43

What occurs with Acute Fatty Liver in Pregnancy?

Answer 43

Diffuse fatty infiltration of liver | --> LIVER FAILURE

Question 44

What are the signs of Acute Fatty Liver of Pregnancy?

Answer 44

``` Abdominal pain N/V JAUNDICE Irritability Polydipsia ```

Question 45

What is the treatment for Acute Fatty Liver of Pregnancy?

Answer 45

Termination of pregnancy... deliver

Question 46

Abdominal pain, N/V, Jaundice is likely what scary condition in a pregnant woman?

Answer 46

Acute Fatty Liver in Pregnancy