Pregnancy Flashcards
What is the definition of gestational thrombocytopenia?
70-150K.
What are the indications for treatment of ITP in pregnancy?
If a patient is symptomatic, if the platelet drop less than 30K, to achieve a platelet count for surgery
What are the first line treatment options for ITP in pregnancy that can be used for all trimesters?
Corticosteroids and IVIG
When can splenectomy be used for refractory ITP in pregnancy?
early 2nd trimester
What are the clinical features of preeclampsia?
BP over 140/90, proteinuria after 20 weeks gestation. If absence of proteinuria they must have end organ damage-low platelet, elevated LFTs, pulmonary edema, or headache.
What is the treatment for preeclampsia?
Delivery at 37 weeks unless they have severe preeclampsia or progressive end organ damage, you can then deliver at 34 weeks. All patients need treatment with aspirin as well.
What is the treatment of HELLP? And for refractory cases?
Delivery asap! Plasma exchange for refractory cases (can also use steroids too).
What is the recommendation for patients who meet the revised Sapporo criteria for APS and have a history of 3 early term loss (less than 10 weeks) or 1 late term loss (greater than 10 weeks)?
Use prophylactic dose of LMWH and aspirin
What is the recommendation for patients who have APS and a history of VTE
You give therapeutic doses of LMWH in combination with aspirin.
What is the recommendation for prior VTE associated with nonhormonal temporary provoking risk factor and no other risk factors?
Suggests against antepartum anticoagulant prophylaxis BUT recommends postpartum anticoagulant prophylaxis
What is the recommendation for Protein C and S deficiency for AC prophylaxis?
For antepartum with and without a family history they recommend against AC. For postpartum they only recommend AC if they have a family history.
What is the recommendation for AC if they have homozygous factor V Leiden?
For all patients regardless of family history these patients will need both antepartum and postpartum prophylaxis.
What is the recommendation for heterozygous factor V Leiden or Prothrombin gene mutation?
For both anepartum and postpartum they recommend against prophylaxis.
What is the recommendation for AC prophylaxis for antithrombin III def?
Only for those with a family history do they suggest giving AC both antepartum and postpartum.
What is the recommendation for any patient desiring pregnancy that has a compound heterozygous thrombophilia?
Regardless of their family history every patient will need both antepartum and postpartum prophylaxis.
