Drugs in pregnancy

Question 1

What complications can self infection drug abuse lead to in pregnancy?

Answer 1

cellulitis, phlebitis, SC tissue infection leading to nectrotizing fasciitis and DVTs

Question 2

What effects do Heroin have on the fetus?

Answer 2

IUGR, fetal distress, risk of sudden infant death, preterm labour

Question 3

What effects do cocaine have on the fetus?

Answer 3

preterm labour, IUGR, fetal distress, abruption of the placenta, premature rupture of membranes, fetal abnormalities especially abdominal wall, developmental delay, aggressive manor

Question 4

What are the potential side effects of cannabis use during pregnancy?

Answer 4

Preterm delivery and low birth weight

Question 5

Potential side effect of benzodiazepines?

Answer 5

Feeding problems due to sedation, some cleft palate

Question 6

Effect that amphetamines have on fetus and babies?

Answer 6

Hyperactivity, symmetrical IUGR, some cleft palate, issues with school and development, premature labour, disordered sleep and feeding

Question 7

What happens if the fetus gains a dependance on barbituates?

Answer 7

Withdrawal seizures

Question 8

What are the physical effects on the mother using amphetamines?

Answer 8

no physical dependance but can cause hypertension and preeclampsia

Question 9

Effects of solvent use on mother?

Answer 9

irritation around the mouth, memory loss, confusion, headache, nausea, coughing, odd behaviour

Question 10

Effect of using solvent on the fetus?

Answer 10

fetal abnormalities like hearing loss, vision or brain damage, IUGR, stillbirth, premature delivery

Question 11

How would you manage a mother who presented with multiple drug addictions?

Answer 11

1. MDT, 2. Explain risks to mother, 3. Screen for associated infections

Question 12

Who would be involved in an MDT approach to drug addictions?

Answer 12

Addictions counsellor, paediatrician, obstetrician, GP, midwife with interest in substance abuse, social worker, dietician

Question 13

Symptoms of neonatal abstinence syndrome?

Answer 13

CNS hyper-irritability, GI dysfunction, high pitched cry, RDS, sneezing, poor feeding

Question 14

What placenta related problems can arise from cigarette smoking?

Answer 14

Placenta abruption, placenta praevia, premature aging of placenta

Question 15

Effects that smoking can have on fetus?

Answer 15

Premature delivery, IUGR, premature rupture of membranes, sudden infant death, ectopics

Question 16

Facial deformaties in FAS?

Answer 16

Short palpebral fissures, short upturned nose, undeveloped philtrum, thin upper lip, low set ears, elongated face, small head

Question 17

CNS effects of FAS?

Answer 17

decreased cranial size, microcephaly, agenesis of corpus callosum, cerebellar hypoplasia, impaired fine motor, hearing loss, bad coordination, mental retardation IQ 67

Question 18

Who would you involve in MDT management of a HIV positive patient?

Answer 18

Obstetrician, paediatrician, specialist nurse, HIV physician, support groups, social worker

Question 19

How do you decrease rates of HIV transmission during pregnancy and early childhood

Answer 19

ART antenatally, intrapartum and post natally, no breastfeeling, CS

Question 20

How do you monitor and test HIV during pregnancy

Answer 20

CD4 cell count, viral load, monitor drug toxicity with FBC, LFT, U&E, lactate, glucose, genital infections

Question 21

What are the main risk factors for transmission?

Answer 21

Vaginal delivery, chorioamnionitis, duration of membrance rupture, preterm delivery

Question 22

Triad of symptoms associated with Reiter’s Syndrome caused by chlamydia?

Answer 22

Arthritis, mucosal ulceration, conjunctivitis

Question 23

What effects can Chlamydia have on babies?

Answer 23

Miscarriage, neonatal conjunctivitis, fitz-high curtis syndrome, reiters syndrome, neonatal pneumonia,

Question 24

What can gonorrhoea cause in babies?

Answer 24

Miscarriage, premature labour, neonatal opthalmia

Question 25

How do you treat chlamydia in pregnancy?

Answer 25

Azithromycin, erythromycin (not doxycycline)

Question 26

How is gonorrhoea treated in pregnancy?

Answer 26

Ampicillin

Question 27

How do you prevent transmission of Hep B?

Answer 27

monitor HbsAg then HbeAg levels as well as immunisation of new born as well as the active immunisation

Question 28

What is the neonatal blood test for syphilis?

Answer 28

VDRL

Question 29

What effects can syphilis have on a fetus?

Answer 29

Failure to thrive, premature, IUGR, bony deformity, liver and kidney disease

Question 30

What are the 3 treatment options of BV in pregnancy?

Answer 30

Metronidazole, clindamycin, ampicillin

Question 31

Is nitrofurantoin safe to take in pregnancy

Answer 31

not in 3rd trimester causes haemolytic anaemia

Question 32

Why should sulphonamides be avoided in 3rd trimester of pregnancy?

Answer 32

Cause neonatal kernicterus

Question 33

What happens if you take tetracyclines in pregnancy?

Answer 33

Discolour teeth and damage bones

Question 34

When should you be careful about taking carbemazepine in pregnancy?

Answer 34

First trimester can cause neural tube defects

Question 35

What effects does phenytoin have on fetus?

Answer 35

Craniofacial and limb abnormalities

Question 36

How does sodium valproate effect fetus?

Answer 36

Neural tube defects and neonatal bleeding

Question 37

2 hormones responsible for heart burn in pregnancy?

Answer 37

Progesterone and relaxin

Question 38

How do hormones cause heart burn in pregnancy

Answer 38

Progesterone and relaxin relax cardiac sphincter and decrease gastric emptying, increased pressure from uterus, pyloric sphincter reflux of bile,

Question 39

What drugs can be given to women suffering heart burn in pregnancy?

Answer 39

Domperidone to help sphincter contraction, H2 antagonists to help relieve oesophagitis and gastritis plus antacid