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Obs & Gynae > Drugs & diseases in pregnancy > Flashcards

Drugs & diseases in pregnancy Flashcards

1
Q

Effects of Benzodiazepines in pregnancy

A

Cleft palate, lip and shoulder

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2
Q

Effects of lithium in pregnancy

A

Heart defect e.g. Ebstein’s anomaly.
Thyroid defect
Floppy baby syndrome 😧

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3
Q

teratogenic anti-epileptics

A

Valproate, carbamazepine

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4
Q

Antidepressants often used in pregnancy

A

SSRI - sertraline, fluoxetine

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5
Q

Transmission of HIV from mum to babba

A

Vertical: via vaginal delivery and breast feeding

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6
Q

Antenatal care of HIV+ve pregnant mum

A 
Treat any infections
Can continue HAART
5mg of folic acid
Plan delivery by 36weeks gestation.
MDT care with HIV physician.
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7
Q

Safe drugs for DM in pregnancy

A

Insulin, metformin

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8
Q

Risks with hyperthyroidism in pregnancy

A

Malformations, prematurity, fetal death.

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9
Q

Good drug for hyperthyroidism in pregnancy

A

Propylthiouracil (less cross of placenta than carboimazole)

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10
Q

Effects of hyperthyroidism on fetus

A

High levels of TSH-R antibodies = fetal thyrotoxicosis.

Fetal TC, goitre, polyhydramnios, prematurity.

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11
Q

Causes of juandice in pregnancy

A

Obstetric cholestasis
Acute fatty liver of pregnancy
Viral hepatitis
HELLP

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12
Q

What to give an epileptic pregnancy woman in last 4 weeks of preg

A

Vitamin K if on hepatic ally excreted anti epileptic med.

And should be on 5mg of folic acid too!

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13
Q

2 drugs to give antiphospholipid syndrome woman

A

Aspirin and heparin

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14
Q

Rubella in pregnancy - affects, detection and treatment

A

Aetiology: airbourne.
S+S for mum: German measles, mild viral symptoms
Fetal effects: Eyes, hearing and cardiac malformations.
Mainly affected in first 16 weeks gestation. The earlier the infection the worse prognosis.
Rx: maternal IgM levels Offer antenatal screening to see if vaccinated (MMR). Offer termination in 1st trimester

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15
Q

CMV in pregnancy - affects and treatment

A

Aetiology: body fluids e.g. sexual contact.
S+S for mum: viral symptoms (fever, headache)
Effects for fetal: deafness, learning disability.

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16
Q

Toxoplasmosis in pregnancy

A

Aetiology: raw or undercooked meat, infected cat faeces.
S+S for mum: none, flu-like symptoms (fever, headache).
Fetal effects: only a risk if maternal infection within 3 months of conception. Epilepsy, hydrocephalus, neurological malformations, hepatosplenomegaly.
Rx = spiramycin to mother.

17
Q

Herpes varicella zoster in pregnancy affects and treatment

A

If acute infection at term, avoid vaginal delivery - C/S.
Early pregnancy, no Hx of chickenpox with mum but contact with a chickenpox patient = give mum V.zoster antibodies as prophylaxis
Develop chickenpox in pregnancy = acyclovir.
Causes eye defects, microcephaly, low IQ, neuro problems.

18
Q

Hepatitis B in pregnancy - detection, affect and treatment

A

Mum’s screening for antibodies in booking appt.
Neonatal hepatitis B, cirrhosis.
Rx = immunoglobulins and vaccinate mum and baby.

19
Q

Complication of a UTI in pregnancy

A

Increase risk of preterm labour

20
Q

Which GBS mum’s to treat with antibiotics

A 
High risk factors:
High vaginal swab positive.
Bacteriuria culture positive.
Premature labour
Hx of previously GBS infected baby
21
Q

ABx for GBS

A

Benzylpenicillin.

22
Q

Effect on fetus of maternal Syphilis during pregnancy

A

Stillborn.

23
Q

Who to give prophylactic LMWH to

A

Women who are at high risk of a VTE should be offered prophylactic LMWH throughout the antenatal period and will usually require prophylactic LMWH for 6
weeks postnatally.
Lower risk women should be offered LMWH postpartum only.

24
Q

Risk factors for VTE in pregnancy

A 
Thrombophilia e.g. Factor V Leiden, protein C or S deficiency.
Pre-eclampsia
Multiple pregnancy
Obese
Increased age (over 35)
Smoker
Parity >3
Hyperemesis
IVF
etc etc
25
Q

Most common cause of hyperthyroidism in pregnancy

A

Graves disease. IgG antibodies involved in the patholphysiology of the disease can cross placenta and damage fetus (preterm, IUGR)

26
Q

What receptors does labetalol act on

A

Combined alpha and beta blocker

27
Q

Organism in Syphilis

A

Treponema pallidum

28
Q

Women who has heart valve replacement and wants to get pregnant, what do you have to consider?

A

STOP WARFARIN!

Change to dalteparin/LMWH

29
Q

Risks of anaemia in pregnancy

A

Low birth weight

Preterm

30
Q

Management of obstetric cholestasis

A

Ursodeoxycholic acid

Piriton for itching

31
Q

Common symptom in hyperthyroidism in pregnancy

A

Excessive vomiting

Obs & Gynae (17 decks)

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