Maternal conditions specific to pregnancy

Question 1

What are the main features of intrahepatic (obstetric) cholestasis of pregnancy

Answer 1

Pruritis (may be intense - typical worse palms, soles and abdomen)
Jaundice

Question 2

How do you monitor in intrahepatic (obstetric) cholestasis of pregnancy

Answer 2

weekly LFTs

Question 3

How do you manage intrahepatic (obstetric) cholestasis of pregnancy

Answer 3

induction of labour at 37 weeks

Topical emollients, antihistamines, ursodeoxycholic acid, vitamin K supplementation, fetal monitoring

Question 4

What are the foetal risks of intrahepatic (obstetric) cholestasis of pregnancy?

Answer 4

IUD
increased risk of premature birth
meconium stained liquor

Question 5

What are the maternal risks of intrahepatic (obstetric) cholestasis of pregnancy?

Answer 5

vitamin K deficiency (from malabsorption)

increased risk of PPH

Question 6

What are the medical management for pre-eclampsia?

Answer 6

1st line - Oral labetalol

Nifedipine and hydralazine may also be used.

Question 7

What are the possible complications for mother with pre-eclampsia?

Answer 7

Renal failure
Liver failure
HELLP syndrome (Haemolysis, Elevated Liver enzymes, Low Platelets)
DIC
Eclampsia
Death

Question 8

What are the foetal risks of pre-eclampsia?

Answer 8

IUGR
IUD
Premature birth

Question 9

What is the most important sign to elicit in a patient with pre-eclampsia?

Answer 9

Brisk tendon reflexes

Question 10

Which medication is used to both prevent seizures in patients with severe pre-eclampsia and treat seizures once they develop?

Answer 10

IV Magnesium Sulphate