Drugs in pregnancy Flashcards

1
Q

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

A

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

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2
Q

What effects do Heroin have on the fetus?

A

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

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3
Q

What effects do cocaine have on the fetus?

A

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

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4
Q

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

A

Preterm delivery and low birth weight

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5
Q

Potential side effect of benzodiazepines?

A

Feeding problems due to sedation, some cleft palate

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6
Q

Effect that amphetamines have on fetus and babies?

A

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

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7
Q

What happens if the fetus gains a dependance on barbituates?

A

Withdrawal seizures

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8
Q

What are the physical effects on the mother using amphetamines?

A

no physical dependance but can cause hypertension and preeclampsia

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9
Q

Effects of solvent use on mother?

A

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

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10
Q

Effect of using solvent on the fetus?

A

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

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11
Q

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

A
  1. MDT, 2. Explain risks to mother, 3. Screen for associated infections
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12
Q

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

A

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

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13
Q

Symptoms of neonatal abstinence syndrome?

A

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

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14
Q

What placenta related problems can arise from cigarette smoking?

A

Placenta abruption, placenta praevia, premature aging of placenta

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15
Q

Effects that smoking can have on fetus?

A

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

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16
Q

Facial deformaties in FAS?

A

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

17
Q

CNS effects of FAS?

A

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

18
Q

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

A

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

19
Q

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

A

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

20
Q

How do you monitor and test HIV during pregnancy

A

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

21
Q

What are the main risk factors for transmission?

A

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

22
Q

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

A

Arthritis, mucosal ulceration, conjunctivitis

23
Q

What effects can Chlamydia have on babies?

A

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

24
Q

What can gonorrhoea cause in babies?

A

Miscarriage, premature labour, neonatal opthalmia

25
How do you treat chlamydia in pregnancy?
Azithromycin, erythromycin (not doxycycline)
26
How is gonorrhoea treated in pregnancy?
Ampicillin
27
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
28
What is the neonatal blood test for syphilis?
VDRL
29
What effects can syphilis have on a fetus?
Failure to thrive, premature, IUGR, bony deformity, liver and kidney disease
30
What are the 3 treatment options of BV in pregnancy?
Metronidazole, clindamycin, ampicillin
31
Is nitrofurantoin safe to take in pregnancy
not in 3rd trimester causes haemolytic anaemia
32
Why should sulphonamides be avoided in 3rd trimester of pregnancy?
Cause neonatal kernicterus
33
What happens if you take tetracyclines in pregnancy?
Discolour teeth and damage bones
34
When should you be careful about taking carbemazepine in pregnancy?
First trimester can cause neural tube defects
35
What effects does phenytoin have on fetus?
Craniofacial and limb abnormalities
36
How does sodium valproate effect fetus?
Neural tube defects and neonatal bleeding
37
2 hormones responsible for heart burn in pregnancy?
Progesterone and relaxin
38
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,
39
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