medical diseases of pregnancy Flashcards
do we treat pregnant women for asymptomatic UTI (asymptomatic bacteruria)? and with what
yes.
amoxicillin
nitrofuratoin
what must you do after treatment of asymptomatic bacteruria
repeat urinanalysis
how do you treat cystitis in pregnancy
same as asymptomatic bacteruria
amoxicillin
nitrofuratoin and repeat
what are the criteria for diagnosing asymptomatic bateruria
no symptoms with positive U/A
what are the criteria for cystitis
urgency, frequency, dysuria, positive sym and UA
what are the criteria for pyelonephritis
urgency, frequency, dysuria, nausea, vomiting, tenderness, fever, chills, positive sym and UA white blood cells and bacteria in the UA
what does a good urianalysis look liek
nitirites, leukocyte esterase, without epithelial cells
what is a positive UA for bacteria colony
> 100,000 colonies
how do we treat pyelo in pregnancy
admit with ceftriaxone and then reassess
what happens if reassess for pyelo is improvement
then 10 days oral course abs with cultures and sensitivity
what happens if reassess for pyelo is no improvement
abscess need ultrasound for draining
thyroid disease in pregnancy what does it cause
hyper -fetal demise
hypo -cretinism
how do we treat hypothyroid
levo.
test TSH levels
usually need to increase by 25% in pregnancy because of increased protein in the blood that binds T4
how to treat hyperthyroid in pregn
PTU or ressection, but have to wait until 2nd trimester.
How to treat seizures
L drugs are safe. leviteracetan and lemotrogine
why do we have to be careful when treating seizures in pregnancy
all epileptics are teratogens.
what meds never use for seizure treatments in pregnancy
valproic acid, carbamezeipime, fenytoin.
what do you do if a pregnant woman has a seizure?
phenobarbitol is safe.
need to give folic acid for NTD
what levels must hypertensino be kept at during pregnancy
lower than usual. <140/<80
what are the safe HTN meds for pregn
alphamethodopa
labetalol
hydralazine
what do we NOT use for HTN in pregnancy and why
ACE inhibitors, ARBs, calcium channel blockers, diuretics. because they are teratogens
Diabetes goals for pregnancy
<7%A1c. diet and exercise. goal is also to remove oral medications and go on insulin.
what insulin strategy used for pregna
basal-bolus. basal level in morning and then bolus for postorandials. need to check daily
what happens to diabetics postpartem
massive reduction in the required insulin.
what happens when diabetes is pre-partem
fetal anamolies such as cardiovascular transposition
what happens with diabetes during pregnancy
macrosomia and increased risk for shoulder.
