endocrinology and hematology of pregnancy Flashcards
in people with hypothyroidism, increase the dose of T4 when become pregnant why
during pregnancy, estrogen induces TBG production. Also HCG increases T4 production. If hypothyroidism, unable to increase the production –> risk for worsening hyothyroidism
pregnancy with hypothyro - T3 or T4
only T4
OCP mediated hypertension - treatment
stop OCPs and use an alternative method for contraception
SERM - SE
- hot flashes
- Venous thromboembolism
- ENdometrial hyperplasia + ca (only tamoxifen)
low estrogen due to hypothalamus –> osteoporosis - treatment
estrogen repletion can offset bone loss, increasing caloric intake and/or decreasing exercise is a more effective means of increasing bone density
Maternal thyroid testing in 1st trimester
increased total T4 and mildly increased fT4: due to HcG and estrogen (stimulates TBG)
Low TSH
estrogen on TBG
increase production and decreased clearance
fetal HR in fetal anemia
sinusoidal HR
causes of hypothalamic amenorrhea
- excessive physical training
- very low calorie diet/starvation
- weight loss
- chronic illness
- stress depression
- anorexia nervosa
functional hypotalamic amenorrhea -vasomotor symptoms?
no
treatment of immature hypothalamic axis of adolescences
progesterone
levothyroxine - placental
it does not cross it
Neonatal thyrotoxicosis - special clinical feature / diagnosis / treatment
- low birth weight or preterm birth
- maternal anti-TSH more than 500%
- treatment: self resolves within 3 months. METHIMAZOL + b blockers
first manifestation of puberty
breast development followed by menarche 2-2/5 years later
insulin resistance in pregnancy due to
increased levels of placental somatomammotropin
ABO hemolytic disease - RF
infants with blood A or B born to a mother with blood type 0
ABO hemolytic disease - clinical features
- jaundice within 24 h
- anemia
- increased reticulocyte count
- hyperobilirubinemia
- coombs positive
ABO hemolytic disease - management
serial bilirubin levels, oral hydration + photoherapy
exchange transfusion for severe anemia / hyperbilirubinemia
anemia of pregnancy is defined as
Hb under 11 in 1st and 3rd trimesters
under 10.5 in the 2nd
euthyroid sick syndrome
low total and free T3 and normal T4/TSH
