passmed Flashcards
what is hyperemesis gravidarum?
sickness ++ during pregnancy due to increased hcg levels
what is associated with a decreased risk of hyperemesis
smoking
what can you give first line for hyperemesis?
an anti histamine (promethazine)
complications of hyperemesis?
wernickes encephalopathy
mallory weiss tear
what complication of chicken pox do you worry about?
pneumonitis
if mother gets chicken pox, what can happen to baby?
fetal varicella syndrome
if there is doubt as to whether the mother has had chicken pox, what should be done?
bloods should be checked for varicella antibodies
if pregnant women not immune to varicella, what should she be given?
zoster imunoglobulin
which drugs are contraindicated when breast feeding?
ciprofloxacin, tetracyclines, aspirin, SUs, amiodarone, methotrexate
first line for anti sickness in pregnancy?
anti histmamine (promethazine)
breast feeding advantages?
bonding
increased involution of uterus
protection against breast and ovarian cancer
cheap
contraceptive effect (although unreliable)
reduced incidence of sudden infant death syndrome
is breast feeding a reliable form of contraception ?
no
what type of infections are reduced from breast feeding?
ear, chest and GI
breast feeding - immunological?
IgA (protects mucosal surfaces), lysozyme (bacteriolytic enzyme) and lactoferrin (ensures rapid absorption of iron so not available to bacteria)
disadvantages of breast feeding?
transmission of infection (women with HIV should be advised to bottle feed)
prolonged breast feeding may lead to vitamin D deficiency
breast milk jaundice
transmission of drugs
can hep b be transferred by breast feeding?
hepaatitis B - no
what is treatment if mother has hep B
give baby the hep b vaccine and immunoglobulin
hyperemsis gravidarum diagnositc creiteria ?
5% pre pregnancy weight loss, dehydration and electrolyte imbalance
postnatal blues time frame?
event by 3rd day, peak by 5th day, subside by 10th day
what is puerperal pyrexia?
defined as a fever of over 38 degrees in the first 14 days following delivery
what is use of an SSRI in late pregnancy associated with ?
withdrawal symptoms
breech presentations - if less than 36 weeks management
leave, most foetus will turn spontaneously
if still breech at 36 weeks?
external cephalic version
main cause of itch without a rash in the third trimester of pregnancy?
obstetric cholestasis
management of obstetric cholestasis?
admit to hospital
ursodeoxycholic acid and sedating antihistamines
what is a complete hydatidiform mole?
empty egg is fertilised by a single sperm
bleeding, exaggerated symptoms of pregnancy, uterus large for dates, very high levels of hcg?
hydatidiform mole
what may also be seen with hydatidiform mole?
hypertension or hyperthyroid
first line for anti sickness in pregnancy?
anti histmamine (promethazine)
breast feeding advantages?
bonding
increased involution of uterus
protection against breast and ovarian cancer
cheap
contraceptive effect (although unreliable)
reduced incidence of sudden infant death syndrome
is breast feeding a reliable form of contraception ?
no
what type of infections are reduced from breast feeding?
ear, chest and GI
breast feeding - immunological?
IgA (protects mucosal surfaces), lysozyme (bacteriolytic enzyme) and lactoferrin (ensures rapid absorption of iron so not available to bacteria)
disadvantages of breast feeding?
transmission of infection (women with HIV should be advised to bottle feed)
prolonged breast feeding may lead to vitamin D deficiency
breast milk jaundice
transmission of drugs
can hep b be transferred by breast feeding?
hepaatitis B - no
what is treatment if mother has hep B
give baby the hep b vaccine and immunoglobulin
hyperemsis gravidarum diagnositc creiteria ?
5% pre pregnancy weight loss, dehydration and electrolyte imbalance
postnatal blues time frame?
event by 3rd day, peak by 5th day, subside by 10th day
what is puerperal pyrexia?
defined as a fever of over 38 degrees in the first 14 days following delivery
what is use of an SSRI in late pregnancy associated with ?
withdrawal symptoms
breech presentations - if less than 36 weeks management
leave, most foetus will turn spontaneously
if still breech at 36 weeks?
external cephalic version
main cause of itch without a rash in the third trimester of pregnancy?
obstetric cholestasis
management of obstetric cholestasis?
admit to hospital
ursodeoxycholic acid and sedating antihistamines
what is a complete hydatidiform mole?
empty egg is fertilised by a single sperm
bleeding, exaggerated symptoms of pregnancy, uterus large for dates, very high levels of hcg?
hydatidiform mole
what may also be seen with hydatidiform mole?
hypertension or hyperthyroid
