Drugs in pregnancy Flashcards
What complications can self infection drug abuse lead to in pregnancy?
cellulitis, phlebitis, SC tissue infection leading to nectrotizing fasciitis and DVTs
What effects do Heroin have on the fetus?
IUGR, fetal distress, risk of sudden infant death, preterm labour
What effects do cocaine have on the fetus?
preterm labour, IUGR, fetal distress, abruption of the placenta, premature rupture of membranes, fetal abnormalities especially abdominal wall, developmental delay, aggressive manor
What are the potential side effects of cannabis use during pregnancy?
Preterm delivery and low birth weight
Potential side effect of benzodiazepines?
Feeding problems due to sedation, some cleft palate
Effect that amphetamines have on fetus and babies?
Hyperactivity, symmetrical IUGR, some cleft palate, issues with school and development, premature labour, disordered sleep and feeding
What happens if the fetus gains a dependance on barbituates?
Withdrawal seizures
What are the physical effects on the mother using amphetamines?
no physical dependance but can cause hypertension and preeclampsia
Effects of solvent use on mother?
irritation around the mouth, memory loss, confusion, headache, nausea, coughing, odd behaviour
Effect of using solvent on the fetus?
fetal abnormalities like hearing loss, vision or brain damage, IUGR, stillbirth, premature delivery
How would you manage a mother who presented with multiple drug addictions?
- MDT, 2. Explain risks to mother, 3. Screen for associated infections
Who would be involved in an MDT approach to drug addictions?
Addictions counsellor, paediatrician, obstetrician, GP, midwife with interest in substance abuse, social worker, dietician
Symptoms of neonatal abstinence syndrome?
CNS hyper-irritability, GI dysfunction, high pitched cry, RDS, sneezing, poor feeding
What placenta related problems can arise from cigarette smoking?
Placenta abruption, placenta praevia, premature aging of placenta
Effects that smoking can have on fetus?
Premature delivery, IUGR, premature rupture of membranes, sudden infant death, ectopics
Facial deformaties in FAS?
Short palpebral fissures, short upturned nose, undeveloped philtrum, thin upper lip, low set ears, elongated face, small head
CNS effects of FAS?
decreased cranial size, microcephaly, agenesis of corpus callosum, cerebellar hypoplasia, impaired fine motor, hearing loss, bad coordination, mental retardation IQ 67
Who would you involve in MDT management of a HIV positive patient?
Obstetrician, paediatrician, specialist nurse, HIV physician, support groups, social worker
How do you decrease rates of HIV transmission during pregnancy and early childhood
ART antenatally, intrapartum and post natally, no breastfeeling, CS
How do you monitor and test HIV during pregnancy
CD4 cell count, viral load, monitor drug toxicity with FBC, LFT, U&E, lactate, glucose, genital infections
What are the main risk factors for transmission?
Vaginal delivery, chorioamnionitis, duration of membrance rupture, preterm delivery
Triad of symptoms associated with Reiter’s Syndrome caused by chlamydia?
Arthritis, mucosal ulceration, conjunctivitis
What effects can Chlamydia have on babies?
Miscarriage, neonatal conjunctivitis, fitz-high curtis syndrome, reiters syndrome, neonatal pneumonia,
What can gonorrhoea cause in babies?
Miscarriage, premature labour, neonatal opthalmia
How do you treat chlamydia in pregnancy?
Azithromycin, erythromycin (not doxycycline)
How is gonorrhoea treated in pregnancy?
Ampicillin
How do you prevent transmission of Hep B?
monitor HbsAg then HbeAg levels as well as immunisation of new born as well as the active immunisation
What is the neonatal blood test for syphilis?
VDRL
What effects can syphilis have on a fetus?
Failure to thrive, premature, IUGR, bony deformity, liver and kidney disease
What are the 3 treatment options of BV in pregnancy?
Metronidazole, clindamycin, ampicillin
Is nitrofurantoin safe to take in pregnancy
not in 3rd trimester causes haemolytic anaemia
Why should sulphonamides be avoided in 3rd trimester of pregnancy?
Cause neonatal kernicterus
What happens if you take tetracyclines in pregnancy?
Discolour teeth and damage bones
When should you be careful about taking carbemazepine in pregnancy?
First trimester can cause neural tube defects
What effects does phenytoin have on fetus?
Craniofacial and limb abnormalities
How does sodium valproate effect fetus?
Neural tube defects and neonatal bleeding
2 hormones responsible for heart burn in pregnancy?
Progesterone and relaxin
How do hormones cause heart burn in pregnancy
Progesterone and relaxin relax cardiac sphincter and decrease gastric emptying, increased pressure from uterus, pyloric sphincter reflux of bile,
What drugs can be given to women suffering heart burn in pregnancy?
Domperidone to help sphincter contraction, H2 antagonists to help relieve oesophagitis and gastritis plus antacid
