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Obs & Gynae (Obs) > Medical Problems in Pregnancy > Flashcards

Medical Problems in Pregnancy Flashcards

1
Q

What happens to the risk of transmission of toxoplasmosis and CMV infections as pregnancy progresses?

A

Increases

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2
Q

What happens to the consequences of infection with toxoplasmosis and CMV as pregnancy progresses?

A

They become less severe

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3
Q

Parvovirus infection in pregnancy only causes foetal complications before what gestation?

A

20 weeks

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4
Q

Rubella infection in pregnancy only causes foetal complications before what gestation?

A

16 weeks

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5
Q

Herpes infection is most likely to cause foetal complications if primary infection takes place when?

A

Third trimester

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6
Q

Infection with toxoplasmosis, especially within the first 10 weeks of pregnancy, is most associated with what complication?

A

Miscarriage

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7
Q

Is there an increased risk of miscarriage with varicella-zoster infection in pregnancy?

A

No

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8
Q

What is the most significant foetal complication of maternal parvovirus infection?

A

Hydrops foetalis

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9
Q

Maternal rubella infection in pregnancy causes the child to develop which type of hearing loss?

A

Sensorineural

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10
Q

Hepatosplenomegaly is most likely to be a foetal feature of which TORCH infection in pregnancy?

A

CMV

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11
Q

Screening for which infections in pregnancy should be carried out after ultrasound detection of congenital anomalies and severe growth restriction?

A

TORCH infections

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12
Q

Women who are known to be HIV positive undergo what monitoring in pregnancy?

A

Viral load and CD4 count at least once every trimester

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13
Q

A positive test for which type of antibody is diagnostic for recent infection with a TORCH organism?

A

IgM

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14
Q

What pattern of IgG serology would confirm the acute disease with a TORCH organism?

A

Increasing titre

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15
Q

What investigations can be used to determine if there is foetal infection with a TORCH organism after the mother has tested positive?

A

Amniocentesis for PCR or culture

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16
Q

What investigation is required to screen for complications of TORCH organisms in foetuses with proven infection?

A

Serial ultrasound scans

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17
Q

In women with pre-existing HIV on anti-retroviral therapy, should this therapy be continued in pregnancy?

A

Yes

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18
Q

In women with pre-existing HIV not on anti-retroviral therapy, when should this be started in pregnancy?

A

By 24 weeks

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19
Q

How should pregnant women with HIV and a viral load of < 50 RNA copies/ml at 36 weeks gestation be delivered of their babies?

A

Vaginal delivery

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20
Q

How should pregnant women with HIV and a viral load of > 50 RNA copies/ml at 36 weeks gestation be delivered of their babies?

A

C-section

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21
Q

Is breastfeeding advised in women with HIV?

A

No

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22
Q

What medication is used to suppress lactation post-natally in women with HIV?

A

Cabergoline

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23
Q

Anti-virals can be used when in pregnancy for women with hepatitis B and a high viral load?

A

Third trimester

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24
Q

Is there any safe drug treatment for hepatitis C in pregnancy?

A

No

25
Q

Does the mode of delivery affect the transmission of hepatitis?

A

No

26
Q

Is breastfeeding advised for women with hepatitis?

A

Yes

27
Q

What additional medication do babies born to hepatitis B positive mothers receive within 12 hours of delivery?

A

Hepatitis B vaccine and a dose of hepatitis B immunoglobulin

28
Q

After a baby born to a hepatitis B positive mother has received the first dose of hepatitis B vaccine at delivery, when should the other doses be given?

A

At 1 and 6 months of age

29
Q

How are women with a primary infection of herpes simplex in pregnancy treated?

A

Aciclovir from 36 weeks

30
Q

How are women with a recurrence of herpes simplex in pregnancy treated?

A

No treatment is required

31
Q

What additional management must be put in place, in addition to aciclovir, for women with a primary infection of herpes simplex in the third trimester?

A

C-section

32
Q

How should women with recurrent herpes simplex infection in pregnancy be advised to deliver their baby?

A

Vaginally

33
Q

Does mode of delivery have any effect on transmission of TORCH organisms?

A

No

34
Q

Does breastfeeding have any effect on transmission of TORCH organisms?

A

No

35
Q

What advice is given regarding weight in pregnancy for women with a BMI > 30?

A

They should aim for a weight neutral pregnancy

36
Q

What prophylactic medications should be offered to all women with obesity in pregnancy?

A

5mg folic acid, 10mcg vitamin D, 75mg aspirin

37
Q

What investigation is used in obese pregnant women to detect early miscarriage, screen for foetal anomalies and assess growth of the foetus?

A

Ultrasound

38
Q

What maternal conditions should be screened for in obese pregnant women?

A

Pre-eclampsia and gestational diabetes

39
Q

What medication is used to reduce the risk of VTE in obese women with additional risk factors?

A

LMWH

40
Q

Women with a BMI > 40 should receive what extra prophylaxis against VTE?

A

Heparin injections for at least 1 week after delivery

41
Q

A first seizure in pregnancy is due to what until proven otherwise?

A

Eclampsia

42
Q

What effect does pregnancy have on seizure frequency in women with epilepsy?

A

No effect

43
Q

Which anti-epileptic drug has the highest risk of foetal abnormalities?

A

Sodium valproate

44
Q

Generally, should anti-epileptic drugs be continued in pregnancy?

A

Yes

45
Q

If sodium valproate absolutely has to be used in pregnancy, what is done to try to reduce the risk of teratogenicity?

A

Split into multiple daily doses

46
Q

How long should women with epilepsy take folic acid supplements for?

A

From pre-conception, all through pregnancy

47
Q

Women with epilepsy taking liver enzyme inducing drugs should also taken which other medication and from what gestation?

A

Vitamin K from 36 weeks

48
Q

Is epilepsy an indication for C-section?

A

No

49
Q

Epileptic seizures can be triggered in labour by pain, anxiety and sleep deprivation. What can be given to try and reduce this risk?

A

Epidural

50
Q

What type of cardiomyopathy is peri-partum cardiomyopathy?

A

Dilated

51
Q

When can peri-partum cardiomyopathy occur?

A

The last month of pregnancy and 6 months after delivery

52
Q

Pregnancy is contraindicated in women with what cardiovascular complication due to the mortality rate being so high?

A

Pulmonary hypertension

53
Q

In general, what happens to symptoms of cardiovascular disease in pregnancy?

A

They worsen

54
Q

What 3 investigations are required to assess maternal wellbeing in pregnant women with cardiovascular disease?

A

ECG, ECHO, exercise testing

55
Q

What 3 investigations are required to assess foetal wellbeing in babies of women with cardiovascular disease?

A

Ultrasound, genetic testing, growth scans from 28 weeks

56
Q

What is used for thromboprophylaxis in pregnant women with metallic heart valves?

A

High-dose heparin

57
Q

What mode of delivery is preferred for women with cardiovascular disease?

A

Vaginal

58
Q

How is oxytocin given to women with cardiovascular disease?

A

Low-dose infusions

59
Q

What medication, often used in labour, is contraindicated in women with pre-existing cardiovascular disease due to the risk of hypertension causing MI and pulmonary oedema?

A

Ergometrine

Obs & Gynae (Obs) (10 decks)

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