Medical Problems in Pregnancy Flashcards

1
Q

What are direct, indirect, and incidental maternal deaths?

A

Directly attributable to pregnancy
Indirect - worsening of preexisting condition
Incidental - not related to pregnancy

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2
Q

How does CO and TPR change in pregnancy?

A

Increases by 50% - at 19 weeks

TPR falls - 8 weeks

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3
Q

How does respiratory change?

A

Hyperventilation and increase tidal volume, reduced functional residual capacity as diahpragm rises

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4
Q

REnal change?

A

GFR increases by 55%

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5
Q

Gastro change?

A

Progesterone reduces LOS tone and GI motility

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6
Q

Metabolic cchange?

A

Hepatic; increased sterod metabolism, diabetogenic

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7
Q

Haemochange?

A

Anaemia of pregnancy, hypercoaguable state

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8
Q

How do you position pregnancy women?

A

L tilt to reduce aorto-caval compression and supine hypotension

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9
Q

How does fluid resus differ?

A

Increase blood volume

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10
Q

How does the airway differ?

A

Increased risk of aspiration

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11
Q

What are the considerations in arrest?

A

Defibrillation is safe
Decide at 4 minutes, delivery by 5 minutes of no output
- Increases the chance of survival of mother and baby
Increase volume of distribution so more fluids

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12
Q

Why is pulmonary HT bad?

A

Because the TPR is going to decrease so pul pressure needs to decrease

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13
Q

What are the implications of increased CO?

A

LV dysfunction
Diseases of fixed output
Aneurysm formation

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14
Q

How is increased heart rate problematic?

A

Decreased ventricular filling time

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15
Q

What are the worst conditions to have in pregnancy?

A

Pulmonary HT

Cyanotic heart disease

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16
Q

What mechanism of delivery is best?

A

Vaginal delivery with spontaneous labour

17
Q

What do you do in the post natal period in cardiac?

A

Diuresis early
Slow oxytocin to avoid PPH
Contraception

18
Q

How do you prevent VTE?

A

Pre-existing risk factor Mx
Intercurrent risk factors - immobilisation, OHSS
Delivery risk factors - long labour, dehydration
Postnatal - immobilisation, dehydration

19
Q

How do you detect of DVT in pregnancy

A

US very sensitive

V/Q scan +/- CTPA

20
Q

How are VTE treated?

A

Low molecular weight heparin - ongoing as well

21
Q

What are low/high risk periods for radiation/imagining?

A

Low:D0-D9 post conception

High: W3-W11 - but no adverse effect at

22
Q

What are the overall recommendations for exposure?

A

No single diagnostic procedure results in a radiation dose significant enough to threaten the well being of developing embryo and foetus

23
Q

What are the 4 M’s of diabetes in the first 13 weeks of pregnancy?

A

Miscarriage
Malformation
Macrosomia
Mortality