Maternal medicine Flashcards
What are the respiratory changes associated with pregnancy?
Increased:
-Tidal volume
-O2 carry capacity.
-Inspiratory capacity (IC)
Decreased:
-Residual volume.
-Expiratory reserve volume.
-Functional residual capacity.
Same:
-Vital capacity.
-Respiratory rate.
-FEV1
In epileptic patients, how much does the seizure risk increase pregnancy?
25%
What effect can myasthenia gravis (MG) have on a pregnancy?
Passive transfer of AchR IgG can lead to:
-arthrogyroposis multiplex congenita (stiff joints)
-polyhydramnios
-neonatal MG.
What medication is contraindicated in labor in patients with MG?
MgSO4
What are the indications for CS with IBD?
1) Active perianal disease.
2) Ileo-anal pouch anastomosis for UC.
What are the risks with active IBD at the time of pregnancy?
PTB, LBW, IUFD, CS, VTE.
What INV medications are contraindicated in pregnancy?
Methotrexate, 5-ASA if contains bibutyl phytlate (DBP).
If IBD patient is on anti-TNF medication and breast feeding, what advice around neonatal vaccination is recommended?
Avoid live vaccines for 6/12.
What pituitary hormones increase in pregnancy?
CRH, ACTH, Prolactin, Oxytocin.
For pre-existing diabetes what are the target blood glucose levels in pregnancy?
1) Fasting < 5.3mmol/L.
2) 1 hour post prandial 7.5mmol/L but 7.8mmol/L for GDM.
3) 2 hours post prandial 6.7mmol/L.
What is the rate of perinatal mortality with DKA on pregnancy?
Up to 35% but < 1% maternal mortality.
What is the recommended weight gain in pregnancy according to BMI?
- Underweight (BMI < 18.5): Recommended weight gain: 12.5
to 18 kg - Normal weight (BMI 18.5-24.9): Recommended weight gain: 11.5 to 16 kg
- Overweight (BMI 25-29.9): Recommended weight gain: 7 to 11.5 kg
- Obese (BMI ≥ 30): Recommended weight gain: 5 to 9 kg
Splitting of the zygote from days 0 to 12 results in which types of twins?
-D0-4: DCDA
-D4-8: MCDA
-D8-12: MCMA
