D/Os in pregnancy

Question 1

Key points of cardiac issures in preg

Answer 1

1. Cardiac output increases
2. Murmurs seen in 90% pt - normal
3. Antibiotic prophylaxis - valvular and structural heart defects
   4.

Question 2

Mx of rheumatic heart disease in preg

Answer 2

Antibiotics during labour

1. Penicillin
2. Gentamicin

Question 3

APA syndrome

Answer 3

1. SLE + recurrent abortions = APA
2. Lupus, anticardiolipin antibody+
3. DOC - Steroid
   Aspirin/heparin(after T1) - prevent preeclampsia/IUGR
4. Baby = neonatal lupus

Question 4

Neonatal lupus

Answer 4

Bllod and cardiac abn
Neonatal bradycardia

Question 5

Thrombocytopenia in preg causes

Answer 5

1. Gestational
2. Immune
3. Sle
4. HELLP - preeclampsia

Question 6

Gestational thrombocytopenia

Answer 6

General FBC done at 36wks
If plt <75 (increase risk of bleeding), Prednisolone for 2 wks

Increase to at least 100

Question 7

Immune thrombocytopenia

Answer 7

Severe
R/o ANA, APS, SLE
*Plt specific antibody

Steroid/IVIG

Question 8

Jaundice during pregnancy causes

Answer 8

1. Viral hepatitis
2. Pre/eclampsia
3. Acute fatty liver - severe but rare, jaundice, vomit, abd pain, headache, coma. Deliver immediately
4. Hyperemesis
5. Cholestatic jaundice of pregnancy

Question 9

Cholestasis of pregnancy

Answer 9

1. d/t oestrogen sensitivity
2. Yellow skin, pruritis - later half of preg
3. preterm birth/fetal distress
4. Refer to specialist
5. LFTs, Vit K supplementation
6. Avoid OCP in future