O&G Pre-existing Maternal Disease

Question 1

Safe anti HTNs in pregnancy

Answer 1

1. Labetalol

2. Nifedipine

Question 2

Contraindicated anti HTNs in pregnancy

Answer 2

ACEi (ramipril)
ARBs (losartan)
Thiazide Diuretics (indapamide)

Question 3

Antenatal care for women with preexisting HTN

Answer 3

BP monitoring
Serial growth scans every 4 weeks from 28w
Low dose aspirin 75mg OD from 12w

Question 4

Antenatal care for women with preexisting DM

Answer 4

Folic acid 5mg until 12w
Low dose aspirin 75mg OD from 12w
Joint DM antenatal clinic every 1 to 2 weeks
Cap glucose monitoring 7 times a day
Specialist foetal cardiac scan 20w
Serial growth scans every 4 weeks from 28w

Question 5

Intapartum Mx for women with preexisting DM

Answer 5

CS or IOL at 37-38+6w
Additional insulin if steroids needed
Sliding scale for women on insulin aiming for blood glucose 4-7 mmol/l

Question 6

Hyperthyroidism tx in pregnancy

Answer 6

1st trimester: propylthiouracil

2nd and 3rd: carbimazole

Question 7

Anti epileptic drug in pregnancy

Answer 7

Lamotrigine

Question 8

Anti epileptic contraindicated in pregnancy

Answer 8

Sodium valproate

Question 8

Anti epileptic contraindicated in pregnancy

Answer 8

Sodium valproate