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AB 4th Year O+G > Obs - Diseases of Pregnancy > Flashcards

Obs - Diseases of Pregnancy Flashcards

1
Q

what is defined as hypertension during pregnancy?

A

≥140/90 twice
≥160/110 once
change of >30/15 to first trimester

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2
Q

risk factors for hypertension during pregnancy?

A 
FHx
BMI
first born 
multiple preg 
birth interval >10yrs
age >40yrs
CM
CTD
Renal disease
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3
Q

features of pre eclampsia?

A 
HT
proteinuria
oedema
headache
vision changes
papilloedema
hyperreflexia
disorientated
oliguria
epigastric/RUQ pain
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4
Q

complications to the fetus if there is pre eclampsia?

A

fetal growth restriction
death
placental abruption

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5
Q

difference between hypertension and pre eclampsia?

A

pre eclampsia is HT + proteinuria

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6
Q

what CVS changes happen during pregnancy?

A

CO increases, drops in last 8 weeks due to IVC compression
HR and SV increases
BP drops in 2nd sem then rises until term
PV increases

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7
Q

how does pre eclampsia occur?

A

failure of vascular remodelling due to abnormal trophoblast invasion

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8
Q

Ix for pre eclampsia?

A 
BP
U+Es, GRF, creatinine
FBC
LFTs
urinalysis 
CTG
US
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9
Q

who is classified as high risk at booking?

A 
Hx 
CKD 
autoimmune disease
DM
chronic HT
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10
Q

who is classified as moderate risk at booking?

A

more than one of the following

first pregnancy 
≥40yrs
pregnancy interval of 10yrs
BMI >35
FHx
multiple pregnancy
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11
Q

how to manage pre eclampsia during pregnancy?

A

labetalol
nifedipine
methyldopa

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12
Q

what is the BP aim for those with pre eclampsia?

A

<150/80

140/90 if proteinuria

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13
Q

what do those with high risk of pre eclampsia get given?

A

75mg aspirin from 12wks

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14
Q

what do those with moderate risk of pre eclampsia get given?

A

75mg aspirin from 12wks

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15
Q

what should be involved in the delivery plan for mums with pre eclampsia?

A

IM steroids if <36wks
IV magnesium sulphate
IV labetalol + hydralazine

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16
Q

what 3rd stage management drug should be avoided in those with pre eclampsia? why?

A

ergometrine

can cause BP spike (risk of stroke)

17
Q

complications of pre eclampsia?

A

stroke
VTE
PO
DIC

18
Q

what is eclampsia?

A

tonic clonic seizures with pre eclampsia

19
Q

Tx for eclampsia?

A 
BP control
roll on left side
IV magnesium sulphate
fluids
delivery baby
20
Q

who is at risk of hyperemesis gravidum?

A

first pregnancy
young
molar pregnancy

21
Q

what can happen as a consequence of hyperemesis gravidum?

A

ketosis
electrolytes altered
LFTs
B1 deficiency

22
Q

Ix for hyperemesis gravidum?

A 
FBC
U+Es
LFTs
urinalysis
clinically dehydrated
23
Q

Tx for hyperemesis gravidum?

A 
fluids
cyclizine/ondansetron/metoclopramide
steroids
thiamine (pabrinex)
PPI for reflux
24
Q

what can occur as a result of B1 deficiency?

A

wernicke’s encephalopathy

25
Q

risk factors for gestational diabetes?

A 
FHx
PCOS
BMI
old age
Hx macrosomic baby
26
Q

features of gestational diabetes?

A

polyuria

polydipsia

27
Q

what changes with regards to blood sugar during pregnancy?

A

wks 1-20 mum is insulin resistant so glycogen is stored

after the reserves are used

28
Q

what Ix is done for gestational diabetes? aim?

A

OGTT
5 6 7 8

at start < 5.6
2 hours after < 7.8 (same as post prandial goal)

29
Q

what extra scan do those with DM get?

A

fetal anomoly (18wks)

30
Q

what should pre existing diabetics be treated with during pregnancy? what extra screening is done?

A

diet
metformin
insulin

retinopathy

31
Q

HbA1c aim during pregnancy?

A

48mmol (<60%)

32
Q

what size of baby should get a CS?

A

> 5kg

33
Q

what fetal complications does gestational diabetes cause?

A 
miscarriage
pre term
cord prolapse
IUGR
macrosomia
malformations
shoulder dystocia
still birth
cerebral palsy
34
Q

risk factors for VTE?

A 
Hx 
thrombophilia
FHx
age 
BMI
parity
smoker
pre eclampsia
prolonged labour
35
Q

what haem changes happen during pregnancy?

A

pro thrombotic

increased platelets, fibrinogen, VII, VIII, X

36
Q

Ix for VTE?

A 
FBC, U+Es, LFTs, clotting
duplex US
V/Q scan  
ECG
CXR
ABGs
37
Q

who gets postnatal LMWH? how long?

A

high risk - 6wks

intermediate - 30days

38
Q

if a pregnant women gets a DVT, what is the Tx?

A

LMWH for 3 months after delivery/6 months after Tx

39
Q

is warfarin safe when breastfeeding? pregnancy?

A

yes

not in weeks 6-12

AB 4th Year O+G (17 decks)

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