Medical Complications in Pregnancy Flashcards
Name seven types of cardiac disease that can present in pregnant women
- Congenital heart disease
- Acquired heart disease
- Pulmonary hypertension
- Cardiomyopathy
- Artificial heart valves
- Ischaemic heart disease
- Arrhythmias
What cardiac diseases are classed as high risk?
Pulmonary Hypertension Presence of cyanosis TIA/arrhythmia Heart failure Left heart obstruction Aortic root >45mm Myocardial dysfunction
Describe the NYHA classification
I - no limitation
II - mild symptoms during activity
III - marked symptoms during daily life
IV - symptoms at rest
What cardiac symptoms are physiological in pregnancy?
Palpitations
Ectopic beats
Sinus tachycardia
What conditions can cause cardiac symptoms in pregnancy?
Hyperthyroidism
Phaeochromocytoma
What tests can investigate heart disease in pregnant women?
ECG FBC TFT Echo US
Describe the effect of hyperventilation in a pregnant woman
PaO2 increases and PaCO2 falls causes a higher arterial pH and alkalosis
Is breathlessness normal or abnormal in pregnancy?
Normal - improves on exertion
What percentage of women will have an acute asthma exacerbation during pregnancy?
10%
What can be given in asthmatic women to cover the stress of labour?
IV Hydrocortisone
Where do most DVTs occur in pregnant women?
Ilio-femoral area
State Virchow’s triad
Hypercoagulability
Venous stasis
Vascular damage
What are the signs/symptoms of a DVT?
Swelling, oedema, leg pain/discomfort, tenderness, increased temperature, lower abdominal pain, increased WCC
How is a suspected DVT investigated?
Compression duplex ultrasound
- normal - repeat in 7 days
- abnormal - MRI venography
What are the signs/symptoms of PTE?
Dyspnoea, chest pain, faintness, collapse, haemoptysis, raised JVP, focal signs in chest, signs of DVT, ECG and CXR abnormalities