Pregnant pts Flashcards
Fetal organ development, length and weight progress in a 40 week pregnancy
around week 20 there is rapid increases in weight/length
endocrine changes in pregnancy
multiple hormonal changes (estrogen, progesterone, etc.)
CV changes in pregnancy
increased CO (20-30%), HR
sometimes flow murmurs present
hematologic changes in pregnancy
increased BV (30%)
Respiratory changes in pregnancy
Increased rate of respiration
levels of a full term pregnanc y
spontaneous abortions
15% chance in first trimester, related to stress/ bacteremia
ectopic pregnancy
implantation of fertilized oocyte in fallopian tube, pain and bleeding seen
Pre-eclampsia and Eclampsia
Pre: HTN and proteinuria
eclampsia: malignant HTN, seizures, encephalopathy, condition in which high blood pressure and proteinuria lead to encephalopathy, coma, miscarriage and death
Hormonal changes can either cause
Hormonal changes can either cause hypertension or syncope
HTN monitored for?
eclampsia
syncope in pregnant pts
Syncope can lead to traumatic injury; prodromal symptoms should be addressed by assuming a prone position
anemia in pregnancy
can occur secondary to hematologic demands
CVD in pregnancy
can be exacerbated in response to increased demands
perio in pregnancy
perio dx could be exacerbated
Pregnancy Gingivitis and Exacerbated Periodontitis Exacerbated by:
- Lack of attention to Oral Hygiene
- Increased systemic fluid levels & capillary fragility from increased progesterone and estrogen
- Increased anaerobic bacterial plaque counts
oral granulomatous pregnancy complication
May cause a granulomatous reaction with a more significant vascular component
Pyogenic granuloma/ Epulis gravidarum/ Pregnancy Tumor
- not an actual granuloma as there is proliferation of vascular tissues as well proliferation of fibrous tissue
- forms submucosally and takes the shape a nodular growth
- Thought to be an exacerbated
esponse to plaque and bacteria precipitated by the changes in hormonal levels
pyogenic granuloma tx options
- variable
*conservative management is an option - May resolve post-partum
- Gentle curettage with electocautery
- Excision to the periosteum and removal of calculus and plaque
Dental Evaluation in Pregnancy in each trimester
specific guidelines for pregnant dental care
when to prohpy?
elective care?
when to restore?
radiographs in pregnancy?
Only when there is an emergency that threatens the health of the mother and child i.e. abcess
primary beam not directed to child bearing area
Rx in pregnant pts?
generally approved?
contraindicated? caveat?
absolutely contra?
low dose ASA is now frequently prescribed BUT only in low doses
what analgesic can be used in all trimesters?
Acetaminophen (tylenol)
Aspirin, IBF, and naproxen are avoided in 1/3 trimesters
what Abx is avoided in pregnancy
tetracycline
can LA with epi bes used in pregnant pts?
yes
NO use with pregnant pts
used at lower levels
can these be used with pregnancy
yes
gestational diabetes
* In some instances, it may also be?
* gestational diabetics are at higher risk of developing?
* symptomatic?
- high blood sugar affecting pregnant women who have insufficient insulin production relative to metabolic needs
- In some instances, it may also be insulin resistance
- gestational diabetics are at higher risk of developing type 2 diabetes later in life
- Generally asymptomatic
when does gestational diabetes present
midterm ~24-28 weeks
gestational diabetes treatment
- daily blood sugar monitoring
- Special meal plans emphasizing a healthy diet
- exercise
- monitoring the baby
- daily blood glucose testing and insulin injections
- If the above conservative measures are not responsive and blood sugar remains high, medication is needed
- IM - Insulin
- PO - Metformin (preferred)
