Pregnancy / Women's Health Flashcards
Lung volume changes in pregnancy?
- Increased tidal volume.
- Decreased RV, ERV, FRC (due to elevation of diaphragm)
- DLCO varies with lung volume
Changes in ABG due to pregnancy
- Chronic respiratory alkalosis, due to increased TV (not rate). +/- compensatory metabolic acidosis.
- Increased Aa gradient
Cardiovascular changes in pregnancy?
- Increased CO 30-50%
- Decreased SVR, PVR, BP
- Postural hypotension in supine position. Left lateral decubitus alleviates.
Pathophysiology of dyspnea in pregnancy?
- Progesterone causes hyperventilation and altered CO2 sensitivity.
- Anemia
- Beware of stenotic cardiac lesions or pulmonary hypertension
Treatment differences of ASTHMA in pregnant patient?
None. Budesonide is specifically studied in pregnancy. Don’t step down. Category B: Cromyln, budosenide, Terbutilide, LAMAs, Monteleukast, Zafirleukast, Omalizumab
Treatment to avoid in status asthmaticus in pregnant patients??
Epi
Diagnostic test of choice for PE in pregnant patients? 2nd line?
V/Q scan, do only Q portion and use smaller contrast load. 2nd best is CT pulm angio.
Treatment of VTE in pregnancy?
LMWH or UFH. Treat through pregnancy + 6 weeks, minimum of 3 months.
Treatment for TB during pregnancy?
INH, Rifampin, Ethambutol for 9 months.
- Use pyridoxine.
- Pyrazanamide not well studied
Treatment of LTBI during pregnancy?
- Low-risk group w/ clear CXR? Delay tx.
- High-risk group? 9 months of INH or 4 months of Rifampin
Treatment of coccidiodomycosis in pregnancy?
Amphotericin (B) or azoles (c)
Treatment of Varicella Zoster in pregnancy?
Acyclovir
Causes of tocolytic pulmonary edema?
Terbutaline or Magnesium (used to stop preterm labor). Exacerbated by steroids.
Timeframe for amniotic fluid embolism?
3rd trimester or 6-9 months postpartum
Treatment for pulmonary hypertension in pregnancy?
Prostacycline, Sildenafil.
-Deliver with Swann in place. Use iNO.
