PE in Pregnancy

Question 0

Pulse oximetry reading less than 90% corresponds to an oxygen tension of?

When to consider giving oxygen?

Answer 0

Less than 60 mm Hg

PO2 < 95

Question 1

Initial diagnostic test for suspected PE in pregnancy?

Answer 1

Spiral CT or MRA

Question 2

Nonpregnant versus pregnant values:

1. PH
2. PO2
3. PCO2
4. HCO3

Answer 2

1. 7.4 versus 7.45 (respiratory alkalosis with partial metabolic compensation)
2. 90-hundred versus 95-105 (increased tidal volume increases minute ventilation)
3. 40 versus 28 (increased title volume increases minute ventilation)
4. 24 versus 19 (renal excretion of bicarb to compensate for respiratory alkalosis)

Question 3

Large cardiac silhouette during pregnancy may indicate? Treatment?

Answer 3

Peripartum cardiomyopathy

Diuretic and ionotropic therapy

Question 4

Patient with dyspnea – think PE if?

Answer 4

Clear CXR in the face of hypoxemia

Question 5

Patient with confirmed PE – regimen?

Answer 5

1. 5-7 days for IV therapy
2. Then Subcutaneous heparin to maintain PTT between 1.5-2.5 for three months
3. Then Prophylactic heparinization for remainder of pregnancy and six weeks postpartum

Question 6

Most common symptom of PE? Most common sign?

Answer 6

Dyspnea; tachypnea

Question 7

Most common cause of maternal mortality?

Answer 7

Thromboembolism

Question 8

EKG findings in PE? Mechanism of findings?

Answer 8

Most common: tachycardia

Right axis deviation
S waves in lead I
Q waves in lead III

(Findings result from strain placed on right heart to pump blood against resistance)