Other Medical Complications of Pregnancy Flashcards
What is diagnosis in woman with persistent vomiting, weight loss > 5%, and ketonuria?
Hyperemesis gravidarum
What are possible treatments for hyperemesis gravidarum?
Phenergan, then reglan, compazine, and tigan
Ginger, vit b12 can help
What is the danger of seizure disorders in pregnancy?
Teratogenecity and fetal malformation with antiepileptic drugs
What is management of patients with seizures?
Folate prior to conception
Reduce use of anti-epileptic drugs to one drug
Fetal survey at 19-20 weeks
Phenytoin (instead of mgso4) with known seizure disorder rather than preeclampsia
What is the pathophysiology behind eisenmenger syndrome?
Initial left to right shunt
Overfilling of right heart = pulmonary HTN and damage
RVH
Right-to-left shunt = chronic hypoxia
Why do patients with aortic stenosis and insufficiency have diminished symptoms during pregnancy?
Decreased SVR reduces afterload
Which valvular disease gets worse with pregnancy?
Mitral stenosis because inability to meet increased demand
Can lead to CHF
What are patients with marfans treated with?
Sedentary lifestyle and beta-blockers
What is perpartum cardiomyopathy?
Symptoms of HF and EF
Which clotting factors are increased in pregnancy?
All except II, V, and IX
What is the idea behind increased pelvic thrombosis?
decreased venous tone due to SMC relaxation with progesterone
Compression of veins by enlarged uterus
What is treatment for DVT and PE?
LMWH
Can warfarin be used during pregnancy?
NO IT IS TERATOGENIC
What TSH levels are aimed for in pregnancy?
Closer to 0.5. Less than 2.5
How should synthroid levels be adjusted during pregnancy?
Increased 25-30% because there is more TBG in pregnancy (estrogen)
