Maternal Medicine Flashcards
How many times greater is the risk of fetal malformations when a patient is on anti-TBF drugs?
Similar to general population
What proportion of patients with MG have a) remission, b) same, c) worsening of symptoms during pregnancy?
a) 30%
b) 30%
c) 40%
What is the risk of PET for previous
a) PET, b) with birth 28-34/40,
c) with birth 34-37/40
a) 16%
b) 33%
c) 23%
What proportion of women with asthma have a) worsening, b) improving, c) same symptoms in pregnancy?
All 33%
What special measures need to be taken for flight in pregnancy with BMI >35?
LMWH
What special measures need to be taken for flight with twin pregnancy?
Don’t fly beyond 32/40
TEDS if > 4 hours
What is the most common benign liver tumour?
Hepatic haemangioma
What are the risks of vertical transmission of parvovirus, a) < 15/40, b) 15-20/40, c) at term
a) 15%
b) 25%
c) 70%
What are the contraindications to cabergoline?
- Pre-eclampsia
- Cardiac valvulopathy
- Hx of pericardial fibrotic disorders
- Hx of pulmonary fibrotic disorders
- Hx of retroperitoneal fibrotic disorders
- Hx of puerperal psychosis
- Hypersensitivity to ergot alkaloids
What is an acceptable value of factors VIII & IX pre-procedure?
0.5
When is red cell exchange transfusion indicated
After RBC transfusion of >1 unit
What dose of anti-D is needed if D +ve platelets (up to 5 units) are given to D -ve women?
250 units
How does vasa praevia typically present?
Fresh PV bleeding at the time of ROM with fetal decelerations
What are the recurrence rates of placental abruption?
After 1, 4.4%
After 2, 19-25%
What is the biggest risk factor for developing hepatic adenoma?
COCP
How often should anti-D be given with recurrent PV bleeding?
6-weekly intervals
What is the incidence of focal nodular hyperplasia?
3%
What proportion of successful IVF results in twin pregnancy?
24%
What proportion of twin pregnancies deliver before 37/40?
50%
How does the perinatal mortality of twins compare to singletons?
3x greater
What is the incidence of hypertensive disorder in pregnancy?
8-10%
What proportion of patients with acute fatty liver of pregnancy a) have renal impairment & b) require renal replacement?
a) 14%
b) 3.5%
What is the risk of malignant transformation of hepatic adenomas?
5%
What proportion of patients with acute fatty liver of pregnancy develop renal impairment?
14%
What is the incidence of diabetes insipidus in pregnancy?
2-4:100,000
What are the minor risk factors for SGA?
- Age 35+
- IVF singleton
- Nulliparity
- BMI <20
- BMI 25-34.9
- Smoker 1-10/day
- Low fruit intake
- Previous PET
- Pregnancy interval < 6 months
- Pregnancy interval > 60 months
What action should be taken for 3+ minor SGA risk factors
UA Doppler 20-24/40
If normal, growth & UA 3rd trimester
If abnormal, serial growth & Doppler from 26-28/40
What are the major risk factors for SGA?
- Age >40
- Paternal SGA
- Maternal SGA
- Cocaine use
- Daily vigorous exercise
- Previous SGA baby
- Smoker > 10/day
- Chronic HTN
- Diabetic vascular disease
- Renal impairment
- Antiphospholipid syndrome
- Heavy PVB
- PAPP-A <0.4 MoM
What action should be taken for 1+ major risk factors for SGA?
Serial growth & Dopplers from 26-28/40
What is the current rate of TB in pregnancy in the UK?
4 per 100,000
When should infliximab be stopped in pregnancy?
16/40
What is the global incidence of conjoined twins?
1 in 100,000
