Medical problems in pregnancy Flashcards
1
Q
If hypothyroid and pregnant - what has to be done?
A
increase levothyroxine by 25-50mcg in 1st trim
- repeat TFTs every trimester
- minimal effect on preg
2
Q
If hyperthyroid and pregnant - what has to be done?
A
Condition worsens in 1st trim. then gets better
Risks:
- IUGR, pre-term labour, thyroid storm
- TFTs every trim
PTU
3
Q
What is the commonest medical disease to complicated a pregnancy, is the treatment of this different to normal? what is emphasis put on?
A
Asthma
- emphasis on prevention
- treatment same as usual
4
Q
Epilepsy:
- what must be given to all pregnant women treated for epilepsy
- what if taking hepatic enzyme inducing convulsant?
A
folic acid 5mg
If taking hepatic enzyme inducing convulsant - vit K 10-20mg from 36wks
-change phenobarbitone due to risks neonatal withdrawal convulsion
5
Q
When is there an increased risk of epileptic seizures in pregnancy?
A
1st trim
- hyperemesis
- haemodilution
6
Q
What are the main reasons for deterioration of epilepsy in pregnancy?
A
- poor compliance
- vomiting = decreased drug levels
- increased vol. of distribution
- increased drug clearance
- lack sleep
- lack absorption drugs during labour
- hyperventilation during labour (offer early epidural)
