Medical disorders affecting pregnancy Flashcards
1
Q
What puts you at serious risk of VTE in pregnancy? (7)
A
- previous VTE
- BMI >30
- age >35
- parity >4
- paraplegia
- sickle cell
- hypovolaemia
2
Q
What tests should be done on suspected PE?
A
- ECG and CXR
- V/Q or CTPA
- Note V/Q can cause child cancer, CTPA bad for breast tissue
3
Q
If you have had PE before in pregnancy what should be done?
When should you consider prophylaxis from start of pregnancy?
What anti-coagulant can not be given?
A
- LMWH for 6 weeks postpartum
- 4 or more RFs
- 3 or more from 28 weeks gestation
- warfarin contraindicated in pregnancy
4
Q
When is VBAC contraindicated?
What is the risks of induction in VBAC?
A
- previous uterine rupture
- classic caesarean scar
- placenta praaevia
- 3 or more previous C-sections
- 3 in 100 chance of uterine rupture
5
Q
advantages of VBAC?
success rate?
A
- shorter recovery time and stay in hospital
- less abdo pain
- less risk of VTE
- 75%
6
Q
What cardiac problem makes pregnancy contraindicated?
What common changes are there in pregnancy ECG?
A
- pulmonary hypertension due to 40% mortality
- Left axis deviation
- inverted T waves
7
Q
What happens to TSH in early pregnancy?
What is hypothyroidism associated with?
What is hyperthyroidism associated with?
A
- increases
- intellectual impairment in children and risk of pre-eclampsia
- rarely causes neonatal thyrotoxicosis
- anovulation
8
Q
What may pregnancy do to a prolactinoma?
A
- cause it to increase, check visual fields
9
Q
What antidepressants should be prescribed?
A
- SSRI preferable to TCA, less toxic
