Obstetrics 1 Flashcards
Good gestational diabetes
Shoulder dystocia
Pre eclampsia
Macrosomia
Who gets LDSC?
IBD patients
HIV with high viral load
Cyclosporin in preg
growth restriction risk
What happens to lamotragine in preg?
Increase clearance
so need to increase 2-3 times to keep therapeutic
If on an enzyme inducing antiepileptic at delivery?
Give kid vitamin K
Migraine women have increase risk SAH when?
Post partum not during labour
What should you do with a hemiplegic migraine who gets pregnant?
Aspirin
What IBD drugs are ok in preg?
Mesalazine, sulfasalazine, steroids
If flare- AZA
Respiratory normal changes in pregnancy?
pH goes up to 7.45 from 7.4; PaCO2 goes down to about 30
RR increases
Tidal vol increases
Alveolar ventilation increases
What happens to asthma in preg?
third worsen
third improve
third same
Good puffer in preg?
Budesonide
Note that if stable on symbicort and seretide- just keep them on it!
VTE- higher risk pre or post partum?
Post partum
Increased risk stable across all trimesters
Higher proportion of what type of DVT compared with non pregnant?
Iliofemoral
Neg DVT scan but clinical suspicion>
Repeat doppler in one week
MRDI (MR direct thrombus imaging)
Venography- but HIGHEST radiation
Major benefit of VQ in preg?
reduced breast cancer risk compared CTPA
If do VQ but non diagnostic scan, then what?
CTPA
Thrombocytopaenia over what level for spinal?
80
over 50 for instrumental delivery
Gestational thrombocytopaenia - what levels
90% are still over 100
can drop to 70
MUST have normal counts in T1 and T2 and normalise post partum
Often recurs with preg
NO increase risk low plt in baby
Note ITP DOES cause low plt in baby and possibly bleeding
TSH upper limits for trimesters?
T1 2.5
T2 3.0
T3 3.5
What deformity does carbimazole give baby?
choanal atresia
Does it help to deliver early in pregnancy if TTP HUS?
No
