Medical problems Flashcards
What 2 antiemetics are useful in pregnancy?
Cyclizine and Metoclopramide.
What do you give to reduce chance of pre-eclampsia?
75mg aspirin from week 12
When is pregnancy induced hypertension?
After week 20.
Main cause of death in pre-eclampsia?
Pulmonary oedema.
In pre-eclampsia, what labour drug should never be used?
Ergometrine. (Due to raised BP)
If previous gestational diabetes, what do u do?
Do a 2hr OGTT at booking then at 24-28 weeks.
WHat is the limit for 2 hour OGTT?
8.5mmmol.
Is thyroxine okay in pregnancy?
Yeas
If someone has antiphospholipid syndrome or past VTEs, what do u do?
Aspirin from conece[room and then LMWH from week 6 to delivery.
What can NSAIDs do?
They can prematurely close the ductus arteiorus.
What can ACEI cause?
Renal hypoplasia.
Diagnostic criteria for gestational hypertension?
DBO > 110 on any occasion.
BP > 140/90 twice
Increase of >30/15 since booking
Symptoms of pre-eclampsia?
Dizziness, Headaches Visual disturbance RUQ or epigastic pain. Rapidly progressiong oedema (face and ankles)
Management of Eclampsia?
Magnesium Sulphaye.
What rheum condition gets better with pregnancy?
RA
What rheum condition flares during pregnancy?
SLE
What do the bloods show in cholestasis of pregnancy?
Mildly increased ALT/AST and increased bilirubin.
Management of itch in cholestasis?
Ursodeoxycholic acid.
What is acute fatty liver of pregnancy?
AFP is an emergency with fat deposition in loibver and usually around weeek 30.
What is the management of pyelonephritis in pregnancy?
Co-amoxilcav.
What is the side effect of SSRI in pregnancy?
May cause pulmonary hypertension if used after 20 weeks.
Baby Blues
3-10 days following delivery, very common and seen in 50% of women.
Tearful anxious etc.
Reassure
Post natal depression.
Onset 2-6 weeks.
Resolution weeks to months but some up to a year.
Similar to baby blues but ore obvious depressive signs.
Puerperal psycho is?
psych emergency due to maternal sucicid.
T
Occurs within 2 weeks of delivery
Risks are bipolar, previous episode, first degree FH.
Management = admit to mom and baby unit.
Alcohol misuse risks in pregnancy?
Low IQ
Hearing proble,s
Heart and kidney malformations.
Facial dysmorphism.
Presentation of vasa praevia
Painless bleeeding following rupture of membranes.
CTG shows fetal distesss.
IF Dx following ROM, Emergency section.
Bloody show:
Loss of cervical mucus plug that develops during pregnancy.
Light vaginal bleeding, nothing else.
Uterine rupture presentation?
Rare complication of fdelivery.
Most commonly seen in obstructed labour in women who has had previous section.
Typical = peritonism, vag bleed and fetal distress with loss of engagement
Management = emergency sectio
