Long term conditions in pregnancy

Question 1

4 complications of hypothyroidism in pregnancy

Answer 1

pre-eclampsia

miscarriage

SGA

anaemia

Question 2

how should levothyroxine treatment be altered during pregnancy?

Answer 2

it should be increased (generally by 30-50%) - there is a greater circulating blood volume and some will cross the placenta

Question 3

levothyroxine treatment should be titrated in pregnancy until levels are…

Answer 3

low-normal

Question 4

3 antihypertensives which are teratogenic

Answer 4

ACEIs

ARBs

thiazide/thiazide-like diuretics

Question 5

3 antihypertensives which are not known to be harmful in pregnancy

Answer 5

labetalol

alpha blockers

calcium channel blockers

Question 6

extra precaution taken by pregnant patients with epilepsy

Answer 6

5mg folic acid (rather than 400mcg)

Question 7

does epilepsy tend to get better or worse in pregnancy?

Answer 7

worse - there are increased stresses/lack of sleep/changes in hormones

Question 8

true or false: seizures are harmful for the foetus

Answer 8

not in of themselves but obviously status is likely to be harmful, as is a fall

Question 9

ideally, before conception, epilepsy should be controlled with..

Answer 9

a single drug (and at the lowest possible dose)

Question 10

3 anti-epileptics which are more safe in pregnancy

Answer 10

levetiracetam

carbamazepine

lamotrigine

Question 11

2 complications of valproate in pregnancy

Answer 11

neural tube defects and developmental delay

Question 12

complication of phenytoin in pregnancy

Answer 12

cleft palate

Question 13

how long should RA be well controlled for before attempting to get pregnant?

Answer 13

3 months

Question 14

how does RA tend to be affected by pregnancy?

Answer 14

symptoms tend to improve (and then worsen after delivery)

Question 15

2 medications for RA which are safe in pregnancy

Answer 15

Hydroxychloroquine

sulfasalazine