Pregnancy Flashcards

1
Q

What is defined as hypertension in pregnancy?

A

> 140/90

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2
Q

What protein:creatinine ratio can be used to rule out proteinuria?

A

< 30

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3
Q

What creatinine represents renal impairment in pregnancy?

A

> 90

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4
Q

What happens to WCC and platelet counts in a normal pregnancy?

A

WCC rises

Platelet count drops

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5
Q

What would explain an isolated ALP elevation in pregnancy?

A

Foetal ALP production

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6
Q

Which time period defines gestational hypertension?

A

Arising after 20 weeks gestation and resolving before 3 months post-partum.

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7
Q

What is the biggest risk factor for pre-eclampsia?

A

Anti-phospholipid syndrome

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8
Q

What anti-angiogenic factors are elevated in pre-eclampsia?

A

SFlt1

Endoglin

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9
Q

What antihypertensives may be used in pre-eclampsia?

A

Labetalol, methyldopa, hydralazine, nifedipine

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10
Q

Which long term risk of pre-eclampsia is most significantly increased (as a relative risk)?

A

End stage renal disease

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11
Q

What is the management of pregnancies with a HBsAg positive mother?

A
  • Viral load high => treat mother with tenofovir in the 3rd trimester
  • Infant should receive Hep B IVIG + 3 x Hep B vaccinations
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12
Q

What is the treatment for Hep C in pregnancy?

A

Supportive

Insufficient eveidence for safety of Hep C meds in pregnancy

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13
Q

What are the features of acute fatty liver of pregnancy?

A
Third trimester
Elevated ALT, AST, bili, INR
Encephalopathy
Hypoglycaemia
Commonly associated with pre-eclampsia
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14
Q

What is the strongest risk factor for acute fatty liver of pregnancy?

A

Multiple pregnancy, eg twins.

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15
Q

What is the cause of acute fatty lver of pregnancy?

A

Associated with a deficiency in an enzyme that metabolises foetal free fatty acids (LCHAD)

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16
Q

What is the treatment of Intrahepatic Cholestasis of Pregnancy?

A

Ursodeoxycholic Acid

- If UDOCA inadequate for symptoms, add cholestyramine

17
Q

How should women with antiphospholipid syndrome be treated during pregnancy?

A

Aspirin if miscarriage x 2 < 10/40 gestation

LMWH+aspirin if miscarriage x 3 < 10/40 gestation or thrombosis or foetal loss

18
Q

What is the benefit of hydroxyurea in pregnant patients with SLE and antiphospholipid syndrome?

A

Reduction in thrombosis, CV deaths and pregnancy losses.

19
Q

Waht are the ligands for sFLT1?

A

VEGF and PIGF