Pre-existing Conditions in Pregnancy and Pregnancy Related Conditions Flashcards
What effects has pregnancy been said to have on asthma?
some say worsening, better or no change, 50% say worsens later in preg
should pregnant women reduce asthma med dose?
no, ONLY if inappropriately high
how often should asthma meds be rvd in preg?
every 4 weeks
What are cat A asthma meds?
salbutamol, budesonide
What class of asthma meds should be avoided in pregnancy?
ICS and LABAs
When could withdrawal of antiseizure meds be considered in preg?
if the woman has been seizure free for >2 years
What antiseizure med has highest rate of birth defects?
valproate; NTDs, autism
what antiseizure meds have lowest risk in preg?
lamotrigine and levetiracetam
what percent of women using antiseizure meds in preg will have infant with major malformation?
2-3%
What are the risks of not treating depression/anxiety in pregnancy?
higher risk preterm, SGA, stillbirth, LBW, autism, PPD
what is the most preferred antidepressant in preg?
sertraline
what antidepressants are associated with heart defects in the infant?
paroxetine and lithium
what can happen to the infant if the mother has been taking antidepressant through pregnancy
toxicity withdrawal
what hypothyroidism drug is recommended in preg and what Cat is it?
levothyroxine Cat A
what percent are thyroid requirements increased in preg?
30% by K4-6
what is the risk of not treating hypothyroidism in preg?
miscarriage
what cat is metformin in preg?
Cat C
What classes of antiHTsives should be avoided in preg and why?
ACEis: fetal renal dysfunction and death, and CCBs: fetal hypoxia
What are the preferred antihypertensives in preg?
methyldopa and labetalol
what are the second line antihypertensives in preg?
hydralazine, nifedipine and prazosin
what are the parameters of GHTN?
140/90 after K20
What percentage of people smoked at some point in preg?
8.3%
what are the effects of smoking in preg?
miscarriage, stillbirth, ectopic, placental issues, PET, SIDS, preterm, birth defects, middle ear infection, T2DM, obesity as adult
what cat is nic replacement therapy?
cat D
when should nic replacement therapy be considered in preg?
when smoking >10cigs/day
can nic cross placenta?
yes easily
what is excessive caffeine linked to in preg and what is this measurement?
miscarriage >600mg daily
what is rec daily limit caffeine in preg?
200mg (2 cups)
what are the effects of cannabis in preg?
major abnormalities, APGARS req NICU, LBW
what can help N&V
ginger and B6
what antiemetics rec in preg?
doxylamine, meto, ondans, promethazine, prochlorperazine
what can excess N&V lead to and how is this treated?
vit deficiencies (B1, assoc Wenicke’s enceph), hyperemesis gravidarium, tx with IV rehydration
what proportion of maternal deaths assoc VTE?
10.6%
how much is VTE risk increased in preg?
4-5 fold
when is greatest risk of VTE for mothers?
PP
When would heparin be CI’d for mothers?
known hypersens, hx hep induced thrombocytopenia, poor renal function EGFR <15L/min
can low molecular weight hep cross placenta?
no
when should warfarin be avoided?
T1, women with prosthetic heart valves, risk teratogenity
