Medical complications in pregnancy and post partum Flashcards
indicators of decreased renal function
decreased GFR
proteinuria
increased uric acid
increased CK/K/urea
kidney produces increased renin which acts on aldosterone II. What are the actions of aldosterone II
vasoconstrictor
increases aldosterone release from renal cortex - increases blood volume
these both lead to hypertension
hepatic complication of pregnancy
hepatic capsule rupture HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)
medication used for pre-eclampsia
- labetalol
- methyldopa
- nifedipine
medications used for severe hypertension in pregnancy
labetalol (oral or IV)
hydralazine (IV)
nifedipine (oral)
when should delivery occur in pre-eclampsia
37 weeks
medication used for VTE in pregnancy
LMWH
if suspected DVT, what is first line investigation in pregnancy
duplex ultrasound of lower limb
treatment for PE/DVT in pregnancy
therapeutic LMWH heparin - treat first
why can heparin be used in pregnancy
doesn’t cross placenta - safe for foetus
SE of heparin
haemorrhage
hypersensitivity
allergy at injection site heparin induced thrombocytopenia
osteopenia
investigations in suspected PE in pregnancy
ABGs
ECG
chest x ray - if normal, duplex Dopplers
if abnormal - CTPA
is warfarin ok in breastfeeding
yes
physiological change on ABGs due to pregnancy
respiratory alkalosis
what medication should be given to those who are epileptic and wish to start a family
folic acid
vit K from 36 weeks if taking hepatic enzyme inducing anticonvulsant
congenital defects associated with epilepsy in pregnancy
neural tube defect
orofacial defects
heart defects
dysmorphic features, hypertelorism, hypoplastic nails and distal digits
why do epileptic mothers have increased chance of seizures in 1st trimester
hyperemesis
haemodilution
maternal risk if epilepsy in pregnancy
status epilepticus
the more anticonvulsants mum is on, the lower/higher the risk
higher
benzodiazepines are teratogenic. true/false
false
