Pre-Existing Conditions in Pregnancy Flashcards
Name 3 antihypertensives that are safe in pregnancy
Labetalol, methyldopa, nifedipine
Which class of diabetic medications is unsafe in pregnancy, and what is the alternative?
Sulfonylureas
Switch to insulin
Chronic HTN increases the risk of what cause of postpartum bleeding?
Placental abruption
Does pregnancy increase MI risk?
Yes (3-4X increased)
Which 2 common antiepileptic drugs are unsafe in pregnancy?
Valproate and phenytoin
What is the management of an intrapartum seizure in a patient with no history of epilepsy?
Mg sulfate
What is the 1st line Mx of an intrapartum seizure in an epileptic PTx?
IV/PR/buccal benzo
What drugs should obese pregnant women be given as prophylaxis in pregnancy? And what for?
LDA against PET
LMWH against VTE
(double check that LMWH is the VTE prophylaxis)
What is the pathology of APS?
Connective tissue disease, acquired thrombophilia
Is a miscarriage of a morphologically normal or abnormal fetus more suspicious of APS?
Morphologically normal
What investigations are done for APS?
Anti-cardiolipin Ab, lupus anticoagulant
2X 6wk apart
When should you suspect a PTx has APS?
3+ miscarriages before 10wk OR 1+ loss >10wk of morphologically normal fetus OR 1+ preterm birth due to PET
What is the Mx of APS in pregnancy?
LDA + monitor
If PMH miscarriage/PET add LMWH
Where is the most common location of DVTs in pregnancy? And which leg is most commonly affected?
Ileo-femoral
Left leg
What two factors during pregnancy increase the risk of DVTs?
Hypercoaguable
Venous stasis
DVTs cause a raised WCC. T or F
True
What test is diagnostic of DVTS in pregnancy?
US
Don’t do d-dimers
What imaging modality is used to see iliac thrombosis?
MRI
What is the DVT prophylaxis drug in pregnancy?
LMWH dalteparin
What is the Mx of DVT in pregnancy?
LMWH dalteparin + postnatal warfarin for 6 weeks
DOUBLE CHECK THIS
What Ix provides a definitive Dx in a suspected PE in pregnancies?
CTPA or VQ scan
What effect does pregnancy have on GFR?
Raised
Hence increased drug elimination
Most drugs cross the placenta. T or F
True
Except those with large molecular weights
Heparin crosses the placenta. T or F
False (large molecular weight)
