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Obstetrics > Maternal antepartum complications > Flashcards

Maternal antepartum complications Flashcards

1
Q

Name the mortality group and rate for - Atrial Septal Defect

A

Group 1

<1%

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2
Q

Name the mortality group and rate for - Ventricular septal defect

A

Group 1

<1%

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3
Q

Name the mortality group and rate for patent ductus arteriosus

A

Group 1

<1%

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4
Q

Name the mortality group and rate for pulmonic/tricuspid disease

A

Group 1

<1%

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5
Q

Name the mortality group and rate for CORRECTED tetralogy of fallor

A

Group 1

<1%

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6
Q

Name the mortality group and rate for porcine valve

A

Group 1

<1%

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7
Q

Name the mortality group and rate for mitral stenosis, NYHA classes 1 and 2

A

Group 1

<1%

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8
Q

Name the mortality group and rate for mitral stenosis with atrial fibrillation

A

Group 2

5-15%

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9
Q

Name the mortality group and rate for artificial valve

A

Group 2

5-15%

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10
Q

Name the mortality group and rate for mitral stenosis (NYHA class 3 and 4)

A

Group 2

5-15%

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11
Q

Name the mortality group and rate for aortic stenosis

A

Group 2

5-15%

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12
Q

Name the mortality group and rate for coarctation of the aorta, uncomplicated

A

Group 2

5-15%

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13
Q

Name the mortality group and rate for uncorrected tetralogy of fallot

A

Group 2

5-15%

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14
Q

Name the mortality group and rate for previous myocardial infarction

A

Group 2

5-15%

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15
Q

Name the mortality group and rate for marfan syndrome w normal aorta

A

Group 2

5-15%

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16
Q

Name the mortality group and rate for pulmonary HTN

A

Group 3

25-50%

17
Q

Name the mortality group and rate for Coarctation of the aorta, complicated

A

Group 3

25-50%

18
Q

Name the mortality group and rate for Eisenmenger syndrome

A

Group 3

25-50%

19
Q

Name the mortality group and rate for marfan syndrome w aortic involvement (>4cm)

A

Group 3

25-50%

20
Q

Blood loss for postpartum hemorrhage

A

Greater than or equal to 1000cc in the first 24hrs following delivery

21
Q

What time frame after delivery is a late (delayed) hemorrhage?

A

Greater than or equal to 1000cc

22
Q

Causes of postpartum hemorrhage (birth to 24hrs)

A

Atony, retained POC, laceration, coagulopathy, uterine inversion, uterine rupture

23
Q

Causes of late (delayed) hemorrhage

A

Retained products, infections (endometritis), subinvolution of placental site, inherited coagulopathies or abnormalities

24
Q

Causes of maternal death w percentage

A

Cardiovascular (14.6%), infection (13.6%), cardiomyopathy (12%), hemorrhage (10%), preeclampsia (9.4%), thromboembolism (9.3%)

25
Q

True or false - peripartum cardiomyopathy is a diagnosis of exclusion

A

True; there is no preexisting cardiac dz or other causes

26
Q

What is the timing of peripartum cardiomyopathy?

A

In the last month of pregnancy or within 5 months of delivery

27
Q

What is seen on echocardiogram in patients with peripartum cardiomyopathy?

A

Left ventricular systolic dysfunction

28
Q

What is the most common cited cause of peripartum cardiomyopathy?

A

Myocarditis

29
Q

What complications are related to peripartum cardiomyopathy>

A

Preeclampsia, acute anemia, multiple, short interim pregnancies

30
Q

Buzz word for peripartum cardiomyopathy

A

Soluble FMS-like tyrosine kinase, oxidative stress, impaired VEGF signaling

31
Q

Mortality rate for peripartum cardiomyopathy

A

10% within 2 years of diagnosis

32
Q

What is the hallmark finding in peripartum cardiomyopathy?

A

Cardiomegaly

33
Q

What is the ejection fraction in patients with peripartum cardiomyopathy?

A

<45%

34
Q

What is the treatment for peripartum cardiomyopathy?

A

Diuretics to decrease preload (central cardiovascular)

Hydralazine to decrease afterload (peripheral vasculature)

Digoxin for inotropic effects (unless complex arrhythmia identified)

Heparin or anticoagulation strongly advised for increased risk of VTE

35
Q

1/2 of all women diagnosed with peripartum cardiomyopathy will regain _____ within 6 months

A

Ventricular function

36
Q

What factors are associated with a worse prognosis (increased deaths) for patients with peripartum cardiomyopathy?

A

Black race
>35-40yrs
LVEF <25%

37
Q

What are diuretics for in the treatment of peripartum cardiomyopathy?

A

Decrease preload (central CV)

38
Q

What is hydralazine for in the treatment of peripartum cardiomyopathy?

A

Decrease afterload (peripheral vasculature)

39
Q

What is digoxin for in the treatment of peripartum cardiomyopathy?

A

Inotropic effects (unless complex arrhythmia identified)

Obstetrics (13 decks)

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