Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3 Reproduction and Sexual Health > Medical Problems in Pregnancy > Flashcards

Medical Problems in Pregnancy Flashcards

1
Q

give examples of direct complications of pregnancy

A

haemorrhage
sepsis
hypertensive disease eg PET

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the main causes of maternal mortality in the UK?

A

cardiac disease
thrombosis/thromboembolism
neurovascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

under/overweight women are at high risk of venous thromboembolism in pregnancy

A

overweight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what should be considered when assessing what impact a medical condition would have on a pregnancy (consider each trimester)?

A 
effects on mum and fetus
drugs
1st trimester - inc risk of miscarriage?
2nd trimester - inc risk of malformation?
3rd trimester- PET? FUGR?
parturition- delivery?
puerperium- problems after birth?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what physiological cardiac factor decreases in pregnancy

A

TPR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is a normal heart rate for a woman at term?

A

90-100bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why is cardiac disease more common in pregnancy?

A

increasing age
increasing BMI
more women with congenital HD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the risk of death from an MI in pregnancy?

A

1 in 13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

woman presents with sudden onset chest pain in pregnancy, what investigation should be done?

A

ECG

consider CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

a pregnant woman presents with orthopnoea, what should be considered?

A

peri-partum cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what kind of hypertension is almost fatal in pregnancy?

A

pulmonary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what anticoagulant should be given to pregnant women?

A

LMWH (doesnt cross placenta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe “normal” palpitations in pregnancy

A

occur at rest and/or lying down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when would a woman’s cardiac symptoms contraindicate her to pregnancy?

A

if she has marked symptoms during daily activities and is asymptomatic only at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

an aortic root >_mm would contraindicate someone to getting pregnant; why is this?

A

45

puts them at increased risk of aortic dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do ectopic beats present? are these normal?

A

“thumping” heartbeat relieved by exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ix for suspected benign palpitations

A

ECG (24hr ECG if worried)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

other causes of sinus tachycardia in pregnancy

A

sepsis
PE
thyroid problems eg hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ix sinus tachycardia

A

ECG
24h ECG
TFT
ECHO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

most common arrhythmia in pregnancy

A

paroxysmal SVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Ix cardiomyopathy

A

ECHO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ix SVT

A

ECG
24h ECG
TFT
ECHO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what tumour can cause palpitations and should be investigated in pregnant women with these symptoms?

A

phaeochromocytoma (do 24hr urinary catecholamines)

24
Q

why do women get breathless in pregnancy?

A

physiological hyperventilation

25
Q

describe the classic presentation of physiological breathlessness in pregnancy

A

SoB at rest/talking that improves with exertion, common in 3rd trimester

26
Q

describe the outcomes of women with asthma in pregnancy

A

1/3 improve, 1/3 stay the same, 1/3 deteriorate

27
Q

who is a greatest risk of deterioration in pregnancy from asthma?

A

those who have been in ICU for asthma
severe disease
cessation of therapy for safety concerns
those who didnt improve in last pregnancy

28
Q

describe asthma treatment pathway in pregnancy

A

SAME AS NORMAL

  1. SABA
  2. add inhaled corticosteroid
  3. add LABA (stop if desnt work)
  4. try inc dose of inh steroid or add 4th drug eg leukotriene receptor antagonist
29
Q

asthma patients should have what kind of delivery?

A

SVD

30
Q

what should women get in labour if they’ve been on oral steroids for >2 weeks

A

IV hydrocortisone

31
Q

where do DVTs occur in pregnancy

A

left leg

32
Q

when is VTE risk highest in pregnancy? why?

A

puerperium

virchow’s triad is most affected have vascular damage from labour, in hypercoaguable state and blood is in stasis

33
Q

prophylactic VTE Tx for high risk pregnant women?

A

LMWH antenatally

34
Q

what puts women at low risk of VTE?

A

less than 3 risk factors

35
Q

what would make a woman at high risk of VTE?

A

any previous VTE not related to surgery

36
Q

prophylactic VTE Tx for low risk mothers

A

mobilisation

hydration

37
Q

why is warfarin not used as VTE prophylaxis?

A

teratogenicity

38
Q

what LMWH is used in tayside? how is the dose worked ou?

A

dalteparin

done by mum’s weight

39
Q

how is DVT diagnosed in pregnancy?

A

compression duplex USS (examination is not always clear)

40
Q

if compression duplex USS is normal but you suspect DVT, what should you do?

A

repeat in 1 week

41
Q

pregnant woman presents with a whole swollen leg and back pain…

A

iliac vein thrombosis

42
Q

d dimers are always up during pregnancy T or F

A

T

43
Q

Ix iliac vein thrombosis

A

MRI venography

44
Q

after how long should a woman previously on warfarin be given LMWH after getting pregnant?

A

6 weeks

45
Q

when can women on LMWH during pregnancy be switched back on to warfarin?

A

can be started on 5th postnatal day

46
Q

skin change in antiphospholipid syndrome?

A

livedo reticularis

47
Q

what precedes the pregnancy loss seen in APS?

A

FGR

48
Q

Ix APS in pregnancy?

A

pregnancy morbidity in PMH
vascular thrombosis
IgM, IgG aCL tests

49
Q

Tx APS in pregnancy?

A

low dose aspirin and LMWH

50
Q

how does seizure frequency change in pregnancy?

A

usually doesnt change

51
Q

what risks does a seizure in pregnancy have on baby?

A

fetal hypoxia and acidosis

= preterm birth, congenital malformations, haemorrhagic disease of newborn

52
Q

what extra investigation should women with epilepsy be given?

A

scan of fetal anatomy at 18-20 weeks

53
Q

what prophylactic medication should women with epilepsy be given?

A

5mg/day folic acid until the end of 1T

54
Q

what factors increase the risk of intra-partum seizures?

A 
stress
pain
sleep deprivation
overbreathing
dehydration
55
Q

Tx seizures in labour

A

benzodiazepines are mainstay

IV lorazepam/diazepam

56
Q

how can you keep babies safe if mum has epilepsy?

A

safe feeding position
do activities on the floor eg dressing, playing
low high chairs
avoid maternal fatigue

57
Q

PET prophylaxis?

A

aspirin

3 Reproduction and Sexual Health (51 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions