Medical problems in pregnancy Flashcards
what drugs are safe for HTN in pregnancy
labetalol
methyldopa (alpha blocker)
nifedipine ( ca channel antagonist)
hydralazine (vasodilator)
HTN in pregnancy BP aim
< 150/80-100
if target organ damage aim for < 140/<90
HTN in pregnancy - when should you deliver?
37 weeks
pre eclampsia - proteinuria > ?
0.3 g/L
diabetic drugs safe in pregnancy
metformin
insulin
diabetic control
- BM aim?
- HbA1c aim?
BM 4-6
HbA1c < 6%
should diabetic tx for GDM be stopped after delivery
yes, stop and monitor BMs for 48 hrs to ensure return to normal
complication of foetal hyperglycaemia
polycythaemia > jaundice, thrombotic effects
how is hypothyroid management changed in pregnancy
increase levothyroxine by 25-50 mcg in first trimester
repeat TFTs every trimester
does hyperthyroid improve in pregnancy?
gets worse in 1st trimester due to HCG but improves in 2nd and 3rd
Ix of DVT
DONT do d dimers
duplex u/s on lower limb
DVT tx?
LMWH
continue until 3m after delivery or 6m after tx, whichever longer
which is safer in pregnancy: CTPA or V/Q scan?
CTPA - less risk of childhood cancer
epileptic taking hepatic enzyme inducing drugs
give vit K from 36 weeks
risk of seizures highest in which period?
peri-partum
how much folate is given in epilepsy
5mg / day
would you encourage to breastfeed in epilepsy?
yes
are BZD’s teratogenic
no
when is C-section indicated in epilepsy
recurrent generalised seizures i late pregnancy
if at high risk of eclampsia, what drug is commenced before 12 weeks?
aspirin
main cause of death in eclampsia
pulmonary oedema
how are seizures in eclampsia treated
mag sulph
if persistent > diazepam
RFs for eclampsia
> 40 yrs BMI > 30 renal disease multi pregnancy fam hx DM
what type of antipsychotics appear to be safe in pregnancy
typicals - haloperidol
