Pregnancy Flashcards
2 supplements recommended for pregnancy
Folic acid 0.5 or 5 12 weeks before and until 1st trimester
Iodine 150 throughout pregnancy
4 Hyperemesis gravidarum criteria
- electrolyte imbalance
- moderate to severe dehydration
- loss of > 5% of body weight
- ketosis
Medication for hyperemesis gravidarum with the least side effects
Pyridoxine or vitamin B6
Cervical shortening cutoff
2.5cm
Drug of choice for antenatal thrombophylaxis
Low molecular weight heparin (enoxaparin)
Postnatal thrombophylaxis
Warfarin and LMWH
Teratogenic effects of warfarin on the 1st trimester
fetal chodrodyplasia punctata
Teratogenic effects of warfarin on the 2nd trimester
mental retardation
fetal optic atrophy
2 definitive tests for PE
Ventilation perfusion syntigraphy and CTPA
7 indications of anti D administration
Spontaneous abortion
ECV
Significant closed intraabdominal trauma
Termination of pregnancy
Chorionic villus sampling
Ectopic
Threatened abortion after 12 weeks
UTI meds for pregnancy
Cephalexin, Coamoxiclav, Nitrofurantoin
What AOG is cerclage best done
22-24 AOG
2 Indications for cerclage
2 ore more consecutive prior 2nd trimester pregnancy losses
3 or more preterm births before 34 weeks
Criteria to qualify as hydrops fetalis (4)
abnormal accumulation of fluid in 2 or more compartments
- ascites
- pleural eff
- pericardial eff
- skin edema (skin thickness >5mm)
conditional:
placental thickening
polyhydramnios
2 types of hydrops fetalis
Immune and non immune
Cause of immune hydrops fetalis
ABO group incompatibility
4 causes of hydrops fetalis
hemolytic disease of the newborn
severe anemia
chromosomal abnormalities
CHD
6 Effects of tabacco during pregnancy
Premature brith
Spontaneous abortion
Low birth weight
Still birth
Placenta previa
Placental abruption (double if >20 cigarettes per day)
Fetal alcohol syndrome facial abnormalities (3)
smooth philthrum
thin upper lip
small palpebral fissures
FAS (3)
Facial abnormalities
CNS
Growth deficit
APAS criteria
1clinical and 1 laboratory (2 positive results 12 weeks apart)
Clinical
Vascular thrombosis
Pregnancy morbidity
Lab
Lupus anticoagulant
Anticardiolipin antibody
Anti B2 glycoprotein antibody
Treatment for APAS
Aspirin and Heparin (LMWH or Unfractionated)
Best time to perform ultrasound to check for physical abnormalities including neural tube defects
18-20
Best time for Down syndrome screening
15-17 weeks
Second trimester screening tests for down syndrome and results (4)
free BHCG increased
AFP dececreased
Unconjugated estriol decreased
Inhibin A increased
When is amniocentesis best done
16-18
When is chorionic villous sampling best done
10-12
Frist trimester serum screening for Down syndrome
Free BHCG inc
PAPP-A decreased
plus nuchal translucency
Safest option for RA in pregnancy
Corticosteroids
Sulfasalazine and HCQ can also be used
6 list of risk factors for cord prolapse
PROM
Polyhy
Breech
Multiparity
Multiple gestation
GDM
What can be given to women who have a history of idiopathic preterm delivery detected by UTZ who do not meet the criteria for cerclage
Vaginal progesterone
7 risk factors for spontaneous abortion
35 years old
smoking
high doses of caffeine
uterine abnormalities
viral infection
thrombophilia
chromosomal abnormlaities
Subarachnoid hemorrhage
- rule out intracranial hemorrhage by CT
- If no intracranial hemorrhage, may give aspirin and do an LP (12 hours after onset of headache)
What cardiac condition can lead to death during pregnancy
MS
Complication of longstanding MS in pregnancy
Pulmonary hypertension
Well tolerated cardiac pathologies during pregnancy (4)
MVR
TR
AR
AS
Contributing factors in the development of pulmonary edema in pregnancy (3)
Increase blood volume
Increase cardiac output
Tachycardia
Most common method of termination of pregnancy before 20 weeks in AUS
Suction curettage
What AOG is suction curettage for abortion most applicable
6-14 AOG
What AOG is medical abortion most applicable
4-9
3 options for medical abortion (cite the 3 meds)
Misoprostol
Mifepristone
MTX
How to give mifepristone?
single dose of mifepristone followed after 2 days by misoprostol q4
How to give Methotrexate
MTX followed by 7 days of misoprostol
Until what AOG is the possibility of spontaneous version
36-37 AOG
5 recommendations for discontinuation of antiepileptic drugs
seizure free more than 2 years
explained risk and benefits
risk of recurrence
withdrawal must be guided by specialist
carried out slowly 3-6 months
4 antihypertensives that are not deemed safe for the baby as they are excreted into breast milk in sufficient amounts to affect the infant.
Atenolol, prazosin, lisinopril, and frusemide
3 antihypertensives safe for both the mother and the baby during lactation.
Propranolol, labetalol, and metoprolol
Fetotoxic Vitamin
Vitamin A
3 antihypertensives safe for both the mother and the baby during lactation.
Propranolol, labetalol, and metoprolol
