Pregnancy Flashcards
What is defined as hypertension in pregnancy?
> 140/90
What protein:creatinine ratio can be used to rule out proteinuria?
< 30
What creatinine represents renal impairment in pregnancy?
> 90
What happens to WCC and platelet counts in a normal pregnancy?
WCC rises
Platelet count drops
What would explain an isolated ALP elevation in pregnancy?
Foetal ALP production
Which time period defines gestational hypertension?
Arising after 20 weeks gestation and resolving before 3 months post-partum.
What is the biggest risk factor for pre-eclampsia?
Anti-phospholipid syndrome
What anti-angiogenic factors are elevated in pre-eclampsia?
SFlt1
Endoglin
What antihypertensives may be used in pre-eclampsia?
Labetalol, methyldopa, hydralazine, nifedipine
Which long term risk of pre-eclampsia is most significantly increased (as a relative risk)?
End stage renal disease
What is the management of pregnancies with a HBsAg positive mother?
- Viral load high => treat mother with tenofovir in the 3rd trimester
- Infant should receive Hep B IVIG + 3 x Hep B vaccinations
What is the treatment for Hep C in pregnancy?
Supportive
Insufficient eveidence for safety of Hep C meds in pregnancy
What are the features of acute fatty liver of pregnancy?
Third trimester Elevated ALT, AST, bili, INR Encephalopathy Hypoglycaemia Commonly associated with pre-eclampsia
What is the strongest risk factor for acute fatty liver of pregnancy?
Multiple pregnancy, eg twins.
What is the cause of acute fatty lver of pregnancy?
Associated with a deficiency in an enzyme that metabolises foetal free fatty acids (LCHAD)
What is the treatment of Intrahepatic Cholestasis of Pregnancy?
Ursodeoxycholic Acid
- If UDOCA inadequate for symptoms, add cholestyramine
How should women with antiphospholipid syndrome be treated during pregnancy?
Aspirin if miscarriage x 2 < 10/40 gestation
LMWH+aspirin if miscarriage x 3 < 10/40 gestation or thrombosis or foetal loss
What is the benefit of hydroxyurea in pregnant patients with SLE and antiphospholipid syndrome?
Reduction in thrombosis, CV deaths and pregnancy losses.
Waht are the ligands for sFLT1?
VEGF and PIGF
