Medical Complications of Pregnancy

Question 1

Hyperemesis gravidarum is suspicious of what type of pregnancy?

Answer 1

Molar

Question 2

Effects of estrogen in pregnancy:

Answer 2

• Increased P450 function
• Increased hepatic metabolism of AEDs
• Decreased seizure threshold

Question 3

Factors affecting coagulability in pregnancy (2):

Answer 3

• Increased production of clotting factors (excluding II, X, and IX)
• Venous stasis

Question 4

Causes of thyroid imbalances in pregnancy (3):

Answer 4

• Increased volume of distribution
• Increased thyroid and sex hormone binding globulin (causing decreased thyroid)
• Increased metabolic demands

Question 5

Graves’ Disease in pregnancy:

Answer 5

• Thyroid-stimulating IG can cross placenta

- PTU and methimazole can also cross placenta

Question 6

Goals of thyroid management:

Answer 6

Keep TSH low

Question 7

Evaluation of lupus flare vs. preeclampsia

Answer 7

C3/C4 levels (low in SLE flare)

Question 8

Effects of SLE on the neonate:

Answer 8

• Maternal Ag-Ab complexes can cross placenta and cause SLE flare in neonate
• Irreversible congenital heart block (anti-Ro/La)

Question 9

Treatment of alcohol withdrawal in pregnancy:

Answer 9

Barbiturates, NOT benzos (potential teratogenicity)

Question 10

Management of thyroid supplementation in pregnancy:

Answer 10

• Increase levothyroxine by 25-30%

- Maintain TSH on lower end of 0.5-2.5

Question 11

Diagnosis of preeclampsia in patients with CKD:

Answer 11

Increase in BP of 30/15 above baseline