Medical Disorders

Question 1

CVS diseases where pregnancy is contraindicated

Answer 1

Eisenmenger syndrome

Primary pulmonary HTN

Severe symptomatic AS
Marfan’s syndrome with aorta dilated > 45 mm
Severe uncorrected coarctation of aorta

Severe MS with complications

Peripartum cardiomyopathy with residual LV dysfunction

Question 2

CVS diseases where I.E. prophylaxis is required

Answer 2

High risk - prosthetic valves, surgical shunts & conduits, previous IE, complex cyanotic CHD

Moderate risk - rheumatic valvular HD, HCM, MVP with regurgitation or thickened leaflets

Question 3

Causes of AKI in pregnancy

Answer 3

Blood loss - abruption, PPH

Contracted volume - severe preeclampsia & eclampsia

Infections - septic abortion & endotoxic shock, acute pyelonephritis, chorioamnionitis, puerperal sepsis

Chronic renal disease

Drug toxicity

Accidental ligation of ureters at CS or CS hysterectomy

HUS & TTP

Question 4

CV diseases where IE prophylaxis is NOT required

Answer 4

Isolated secundum ASD

Sx repair of ASD, VSD, PDA
Previous CBG surgery
Cardiac pacemaker

MVP without regurgitation

Previous Kawasaki disease w/o valvular dysfunction

Previous rheumatic fever w/o valvular dysfunction

Question 5

Asymptomatic bacteriuria

Answer 5

Persistent & actively multiplying bacteria within the urinary tract with NO symptoms s/o UTI

> 100,000 bacteria of the SAME species per mL in a clean voided specimen

Prevalence high in those with sickle cell trait

Question 6

MC bacterial infections seen in pregnancy

Answer 6

UTI

2 types -

Asymptomatic
Symptomatic - cystitis, pyelonephritis

Question 7

MC organisms causing UTI

Answer 7

E.Coli (90%)

Klebsiella
Proteus
Pseudomonas

Question 8

Factors determining pregnancy outcome in chronic renal disease

Answer 8

HTN predating pregnancy

Renal function (Impairement based of creatinine level) 
       Mild  3

Type of renal disease - worse prognosis for
Lupus nephropathy
Scleroderma
PAN

Question 9

MC renal pathology in obstetrics

Answer 9

Acute tubular necrosis

• Kidneys enlarged
• pale cortex, darker medulla
• Microscopy: renal tubules ischemic & necrotic, blocked with casts

Renal function will recover in 1 or 2 weeks, if promptly treated

Question 10

Pregnancy following renal transplant

Answer 10

Pregnancy can be safely undertaken by 1 year after the transplant

Prerequisites :

• good general health for atleast 1 yr since the transplant
• no evidence of graft rejection
• stable renal function (s.creat

Question 11

Maternal complications in GDM

Answer 11

preeclampsia
Polyhydramnios
infections
operative delivery
genital trauma
puerperal sepsis
wound infection
Ketoacidosis

Question 12

Fetal complications in GDM

Answer 12

prematurity
macrosomia
IUGR
miscarriage
congenital malformations
unexplained fetal demise

Question 13

Neonatal complications in GDM

Answer 13

RDS
hypoglycemia
polycythemia
hyperbilirubinemia
hyperviscosity syndrome
cardiomyopathy
birth trauma

Question 14

Fetal complications in PIH

Answer 14

IMMEDIATE

• prematurity
• IUGR

LATE
- Long term CV morbidity

Question 15

Chronic renal disease with worst prognosis

Answer 15

Scleroderma