Lecture 14: Medical Conditions in Pregnancy Flashcards
What type of anesthesia is preferred in patient with primary pulmonary HTN?
Epidural anesthesia and vaginal delivery MAY be an option
What is the cause of neonatal thyrotoxicosis; lasts how long?
- Placental transfer of thyroid stimulating antibodies
- Transient (lasting 2-3 months)
When should renal function and opthalmic function be assessed in pregnant pt with preexisting diabetes?
- Renal = 24-hour urine collection every trimester
- Opthalmic = detailed eye exam in first trimester
Superficial thrombophlebitis is most common in pregnant pt’s with what characteristics; risk of PE?
- Most common in those w/ varicose veins, obesity and little physical activity
- Most common in calf, will NOT result in PE
In mother with GDM, which fetal weight warrants C-section delivery?
>4500 gm
When should coumadin be used during pregnancy for DVT’s?
Used for 6 weeks POST-partum, but NOT during pregnancy
Who is at greatest risk of developing postpartum cardiomyopathy?
Women w/ preeclampsia, HTN and poor nutrition
If patient has DVT what values should you follow if you give LMW lovenox vs. unfractionated heparin to assure therapeutic levels?
- Follow aPTT values with heparin
- Factor Xa values with lovenox
Triggers of thryoid storm in pregnancy can be infection, labor, C-section, and non-compliance to meds; what are signs/sx’s?
- Hyperthermia
- Tachycardia
- Perspiration
- High output cardiac failure
Which drug for hyperthryroidism is contraindicated throughout pregnancy?
Radioactive iodine
What are sx’s of PE during pregnancy?
- Pleuritic chest pain
- Shortness of air
- Air hunger
- Palpitations
- Hemoptosis
What is the most common pulmonary disease in pregnancy?
Asthma
Intrahepatic cholestasis of pregnancy increase the risk of what complications?
Meconium stained amniotic fluid and fetal demise
How soon postpartum should a 2-hour OGTT be performed in mother who had GDM?
6-12 weeks post-partum to look for pre-existing disease
What is the most common cause of anemia during pregnancy and when do you screen these pt’s?
- Iron deficiency
- Screened at initial prenatal visit and again at 26-28 weeks
Which serum creatinine level worsens the prognosis of chronic kidney failure during pregnancy?
Serum Cr. >1.5-2