Medical Disorders in Pregnancy Flashcards
What is defined at Hypertension in pregnancy according to NICE?
140/90-159/109 mmHg
What is defined as severe HTN according to NICE?
> 160/110mm Hg
Define chronic HTN
HTN before 20 weeks in absence of hydatiform mole or persisting 6 weeks postpartum
Define pre-eclampsia
HTN after 20 weeks with one of proteinuria, maternal organ dysfunction or fetal growth restriction
Define eclampsia
Generalised tonic clonic seizure in women with pre-eclampsia if seizures not attributable to another cause
Give 4 risks of pre-eclampsia
- 1st pregnancy
- Fx (mother or sister)
- Extremes of maternal age
- Obesity
Give 5 symptoms of pre-eclampsia
Severe headache
Severe RUQ pain
Swelling of face/hands/feet
Visual disturbance
Vomiting
Give 5 signs of pre-eclampsia
- HTN
- Proteinuria
- Hyperreflexia
- Raised creatinine
- Decreased platelets
What can be used as pre-eclampsia prevention in women with chronic HTN?
150mg aspirin from 12 weeks
What is the 1st line management for HTN if systolic 150-160?
Labetalol
in severe pre-eclampsia
(systolic>180) give 3 anti-hypertensives which can be used
o Oral/IV labetalol
o Oral nidedipine
o IV hydralazine
What can disrupted fluid balance in pre-eclampsia cause?
Too little: renal failure
Too much: pulmonary oedema
What is used to treat or prevent eclamptic seizures?
Magnesium sulphate
Give 3 maternal complications of pre-eclampsia
- Placenta rupture
- DIC
- HELLP
Give 3 fetal complications of pre-eclampsia
- IUGR
- Pre-term delivery
- Perinatal death
What is HELLP?
Haemolysis, elevated liver enzymes, low platelets
Give 4 risk factors for gestational diabetes
BMI>30
Previous GD
Previous macrocosmic baby
FX diabetes
What should be done if one risk factor of gestational diabetes is identified at booking?
Offer 2hr 75g OGTT at 24-28 weeks
Give 3 pharmacological treatment options for gestational diabetes
Metformin
Glibenclamide
Insulin
In cases of gestational diabetes, when should delivery occur?
No later than 40+6
Give 3 effects of thyrotoxicosis on pregnancy
Miscarriage
IUGR
Preterm delivery
Up until which point is fetal thyroxine obtained from the mother?
12 weeks
Give 2 pharmacological treatments for hyperthyroidism in pregnancy
Carbimazole
Propanolol
Give 3 effects of epilepsy on pregnancy
- Seizure activity in 1st trimester
- Decreased drug levels
- Impaired sleep
Can placental transmission occur during varicella zoster infection of the mother?
Yes
At which level of viral RNA copies/ml would a normal vaginal delivery be considered?
<50 copies = normal delivery
How should neonates be treated postnatally if the mother has HIV?
HIV post exposure prophylaxis within 4 hours of birth
Give 3 situations in which anti-D would be required to be administered in a Rh negative mother
- After management of ectopic
- <12 weeks heavy vaginal bleed
- <12 weeks medical/surgical management of miscarriage
Which areas of the body does an atopic eruption of pregnancy effect?
Trunk and limbs
Give 3 treatment options for atopic eruption of pregnancy
Emollient
Topical steroid
Antihistamine
When and which areas of the body does polymorphic eruption of pregnancy effect
3rd trimester - postpartum
Lower abdomen and striae with UMBILICAL SPARING
Give 3 treatment options for polymorphic eruption of pregnancy
Emollient
Topical corticosteroid
Sedating antihistamine
Define pemphigoid gestationis
Rare condition of 2nd/3rd trimester caused by AI binding of IgG to basement membrane
Give 3 skin features of pemphigoid gestationis
Urticarial lesions
Wheals and bullae
Umbilical area affected
Give 3 management options for Pemphigoid Gestationis
Topical steroid
Systemic corticosteroid
REFER TO DERM AND OBSTETRICS
Give 4 common skin changes which occur during pregnancy
Hyperpigmentation
Striae gravidarum
Angiomas
Greasier skin
