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Reproduction and sexual health > Medical problems in pregnancy > Flashcards

Medical problems in pregnancy Flashcards

1
Q

list cardiac problems in pregnancy

A 
pulmonary hypertension 
ischaemic heart disease 
valve disease 
arrhythmias 
peri-partum cardiomyopathy 
congenital heart disease
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2
Q

pulmonary HTN is fatal in pregnancy, true or false

A

true

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3
Q

list causes of palpitations

A 
physiological 
sinus tachycardia 
SVT
Ectopic beats 
hyperthyroidism 
phaeochromocytoma
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4
Q

there is an increase/decrease in residual lung capacity in pregnancy

A

decrease

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5
Q

what is the commonest respiratory condition to complicate pregnancy

A

asthma

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6
Q

is treatment of asthma in pregnancy any different to normal treatment of asthma

A

no, same treatment

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7
Q

steroids are safe/unsafe in pregnancy

A

safe

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8
Q

what should you look out for in pregnant women taking steroids

A

weight gain –> GDM

immunosuppression –> infections, vaccines

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9
Q

what is the management of asthma

A
  1. SABA
  2. SABA + ICS
  3. SABA + ICS + LABA
  4. Increase ICS dose
  5. add 4th drug
  6. PO prednisolone
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10
Q

which drugs should be avoided in pregnant asthamtics

A

NSAIDs and haemabate

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11
Q

what happens to the risk of VTE in pregnancy

A

increases!

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12
Q

where are VTEs most commonly found

A

ileofemoral region in left leg

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13
Q

what is Virchows triad

A

hypercoaguability
venous stasis
vascular damage

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14
Q

LMWH is/not safe to use in pregnancy and does/not cross the placenta

A

safe to use and does not cross the placenta

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15
Q

which imaging technique is safer to investigate PE in pregnant women and why

A

V/Q scan

avoid high dose radiation

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16
Q

warfarin does/not cross the placenta

A

DOES cross the placenta

therefore teratogenic

17
Q

when should you convert warfarin to LMWH in pregnancy

A

6 weeks

18
Q

which anticoagulants can be used post natally

A

heparin and warfarin (can be used in breast feeding)

19
Q

what are pregnancy complications of autoimmune disorders

A 
miscarriage 
PET
abruption 
FGR
stillbirth 
prematurity
20
Q

what are treatment related consequences of connective tissue disorders

A

teratogenic medications
sepsis
DM
osteoporosis

21
Q

autoimmune conditions tend to get better/worse in pregnancy

A

better

22
Q

which CTD medications are safe to use in pregnancy

A 
steroids 
azathioprine
sulfasalazine 
HCQ 
aspirin 
monoclonal antibodies
23
Q

which CTD medications are NOT safe to use in pregnancy

A 
gold 
penicillamine 
methotrexate 
NSAIDs
MMF
leflunamide
24
Q

what is anti-phospholipid syndrome

A

acquired thrombophilia with aterial, venous and small vessel thrombosis

25
Q

clinical features of APLS

A

recurrent miscarriages, DVT/PE, stroke, MI

IUGR, PET

26
Q

antibodies of APLS and how do you test for these

A

anti-cardiolipin
anti-B2glycoprotein
lupus anticoagulant

2 tests, 3 months apart

27
Q

how do you diagnose APLS

A

> =3 miscarriages <10wk
=1 foetal loss >10wk
=1 preterm birth due to PET or placental insufficiency

28
Q

management of APLS

A

low dose aspirin
stop warfarin
LMWH

29
Q

risks of maternal seizures

A 
maternal abdominal trauma eg haemorrhage 
Pre term premature rupture of membranes
prematurity 
hypoxia/acidosis 
foetal abnormalities 
haemorrhagic disease of the newborn 
childhood epilepsy
30
Q

which AED is not teratogenic

A

lamotrigine

31
Q

which AED are teratogenic

A

Na valproate
phenytoin
carbamazepine

32
Q

what increases the risk of peri partum seizures

A 
stress
pain 
sleep deprivation 
hyperventilation 
dehydration
33
Q

management of intra partum seizures

A

long acting BZD
AED through labour
c-section if high risk of SE
left lateral tile to avoid comrpession of aortocaval vessels

34
Q

consequences of obesity in pregnancy

A 
subfertility 
miscarriage 
IOL, instrumental delivery 
PPH, infection, VTE
foetal macrosomia, bith injury
35
Q

foetal abnormality common in mothers with DM

A

VSD

36
Q

if there is a high suspicion of DVT but the scan is clear what could you do

A

give LMWH - see doses on NICE or RCOG

time it with delivery to prevent haemorrhage

37
Q

is warfarin teratogenic

A

yes

38
Q

is warfarin teratogenic

A

yes and it can anticoagulate the baby and cause IVH

Reproduction and sexual health (46 decks)

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