obstetrics

Question 1

Risk factors for pre-eclampsia? Possible protective factors?

Answer 1

• nulliparity
• obesity
• pre-partum HTN
• personal and/or family hx of pre-eclampsia
• pregestational diabetes
• SLE, APLS (APLS = greatest RF)
• CKD (s3/4/5)
• Multifetal pregnancy
• previous placental insuffiency
• older age
• ivf

CO and smoking possibly protective

Question 2

Effects of TRABs on fetus?

Effects of TPO-antibodies?

Answer 2

TPO antibodies = increased chance of miscarriage

TRabs cross placenta –> can cause thyrotoxicosis

Question 3

What LFTs decrease during pregnancy?

Answer 3

AST, ALT, GGT, Bilirubin, Albumin

ALP increases

Question 4

Indications for treatment of hepatitis B in pregnant women?

Answer 4

HBV viral load >2000* + raised ALT (x2 ULN)
HBV viral load >200, 000 regardless of ALT (2 x 10 to the power of 5)

*20, 000 as per UTD if Hbeag +ve

Basically same as non-pregnant women

Question 5

Thrombophilia with highest risk of VTE in pregnancy

Answer 5

Factor 5 leiden homozygous (I think)

Other sources- antithrombin (AT) deficiency

Question 6

Control of moderate HTN results in what?

Answer 6

Reduced risk of

• neonatal respiratory distress syndrome
• severe hypertension
• labor induction
• maternal stroke

DOES NOT reduce risk of pre-eclampsia or perinatal mortality