Pre-Existing Conditions in Pregnancy Flashcards

1
Q

Name 3 antihypertensives that are safe in pregnancy

A

Labetalol, methyldopa, nifedipine

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2
Q

Which class of diabetic medications is unsafe in pregnancy, and what is the alternative?

A

Sulfonylureas

Switch to insulin

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3
Q

Chronic HTN increases the risk of what cause of postpartum bleeding?

A

Placental abruption

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4
Q

Does pregnancy increase MI risk?

A

Yes (3-4X increased)

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5
Q

Which 2 common antiepileptic drugs are unsafe in pregnancy?

A

Valproate and phenytoin

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6
Q

What is the management of an intrapartum seizure in a patient with no history of epilepsy?

A

Mg sulfate

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7
Q

What is the 1st line Mx of an intrapartum seizure in an epileptic PTx?

A

IV/PR/buccal benzo

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8
Q

What drugs should obese pregnant women be given as prophylaxis in pregnancy? And what for?

A

LDA against PET
LMWH against VTE

(double check that LMWH is the VTE prophylaxis)

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9
Q

What is the pathology of APS?

A

Connective tissue disease, acquired thrombophilia

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10
Q

Is a miscarriage of a morphologically normal or abnormal fetus more suspicious of APS?

A

Morphologically normal

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11
Q

What investigations are done for APS?

A

Anti-cardiolipin Ab, lupus anticoagulant

2X 6wk apart

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12
Q

When should you suspect a PTx has APS?

A
3+ miscarriages before 10wk
OR
1+ loss >10wk of morphologically normal fetus
OR
1+ preterm birth due to PET
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13
Q

What is the Mx of APS in pregnancy?

A

LDA + monitor

If PMH miscarriage/PET add LMWH

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14
Q

Where is the most common location of DVTs in pregnancy? And which leg is most commonly affected?

A

Ileo-femoral

Left leg

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15
Q

What two factors during pregnancy increase the risk of DVTs?

A

Hypercoaguable

Venous stasis

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16
Q

DVTs cause a raised WCC. T or F

A

True

17
Q

What test is diagnostic of DVTS in pregnancy?

A

US

Don’t do d-dimers

18
Q

What imaging modality is used to see iliac thrombosis?

A

MRI

19
Q

What is the DVT prophylaxis drug in pregnancy?

A

LMWH dalteparin

20
Q

What is the Mx of DVT in pregnancy?

A

LMWH dalteparin + postnatal warfarin for 6 weeks

DOUBLE CHECK THIS

21
Q

What Ix provides a definitive Dx in a suspected PE in pregnancies?

A

CTPA or VQ scan

22
Q

What effect does pregnancy have on GFR?

A

Raised

Hence increased drug elimination

23
Q

Most drugs cross the placenta. T or F

A

True

Except those with large molecular weights

24
Q

Heparin crosses the placenta. T or F

A

False (large molecular weight)

25
Q

Is warfarin safe in the 1st trimester? If no, why not?

A

Teratogen

26
Q

Is warfarin safe in the 3rd trimester? If no, why not?

A

Increases risk of APH / PPH

27
Q

Is warfarin safe in breastfeeding?

A

Yes

28
Q

Are ACEIs safe in pregnancy?

A

No

29
Q

Are ARBs safe in pregnancy?

A

No

30
Q

Are statins safe in pregnancy?

A

No

31
Q

What does amiodarone cause if taken whilst breastfeeding?

A

Hypothyroidism

32
Q

What drug is 1st choice for nausea in pregnancy?

A

Cyclizine