Kidney disease in pregnancy Flashcards
What is the risk of pre-eclampsia in a woman with hypertension?
25% risk
Proteinuria increases risk for pre-eclampsia. True/False
False, but it results in poor outcome for the foetus. Concurrent elevated dBP and proteinuria is the greatest risk for poor foetal outcomes.
Control of BP in pregnancy results in reduced risk of pre-eclampsia. True/False
False; the only shown benefit is a reduction in severe hypertension
There is no risk associated with CKD Stage 1 in pregnancy. True/False
False
Increases risk of IUGR, NICU admission, C-section, pre-eclampsia
The risk of foetal demise is higher among women who have donated one of their kidneys. True/False
True
Past history of AKI, regardless of normal current function, is predictive of pre-eclampsia. True/False
True
What is the most common cause of nephrotic syndrome in women world-wide?
Pre-eclampsia
How long (in general) should you wait before becoming concerned about proteinuria post-partum?
3 months (in general), but time to resolution is dependent on the degree of proteinuria.
At what gestation does pre-eclampsia tend to first occur?
20 weeks GA
What is the most common cause for AKI (by mechanism) in the peripartum and postpartum period?
TMA
Genetic defects in the complement system leading to aHUS typically affect what factor?
Factor H
ACEi are safe in breast feeding women. True/False
True
What percentage of pregnancies in transplant patients result in live births?
75-85%
What is the median gestational age that transplant patients achieve?
35 weeks
How long after transplant should a patient wait before becoming pregnant?
1-2 years
What is the main differentiating factor between TTP and C-TMA in pregnancy?
The time to onset.
TTP generally occurs in the second and third trimesters whereas C-TMA occurs post partum
What is the pathogenesis of acute fatty liver of pregnancy?
It occurs secondary to an autosomal recessive genetic error that results in defective long-chain 3 hydroxy acyl CoA dehydrogenase. This leads to abnormal fatty acid oxidation in mitochondria. The excess in fatty acids spills into the maternal circulation from the foetal circulation. This causes the liver injury.
Talk a little bit about delivery in pre-eclampsia
You should deliver women with pre-eclampsia once they have reached 37 weeks, but the name of the game is to prolong the pregnancy as long as is possible without jeopardising maternal or fetal well being.
At what level of hypertension is antihypertensive treatment recommended in pre-eclampsia?
All patients with blood pressure >160/100
What is given as seizure prophylaxis in severe hypertension in pregnancy?
IV MgSo4 4g over 15 mins then 1-2g per hour
