Problems In Pregancy

Question 1

What’s the treatment for hypertension in pregnancy?

Answer 1

Labetalol > nifedipine >methyldopa

Take aspirin from 12wks.
Ace causes renal agenisis

Question 2

Which drug to use in hyperthyroid in pregnancy?

Answer 2

Propylthiouracil

Less like to cross placenta than carbimazipine

Question 3

Treatment for urinary tract infection in pregnancy?

Answer 3

Nitrofurantoin.

Avidity trimethoprim in first trimester as it’s an anti-folate drug

Question 4

What investigation might indicate acute fatty liver in pregnancy?

Answer 4

LFT - ALT elevated eg. > 500

Question 5

What are the changes in anaemia values in pregnancy?

Answer 5

Anaemia is 
1st T: <110g/l
2nd t: <105
3rd T: <105 
Postpartum <100g/l

Rx: oral iron

Question 6

What happens with rubella in pregnancy?

Answer 6

Fetus is at risk 4-10 weeks. Risk reduces after 1st trimester
Features: sensorineural deafness, cararacts, congenital heart disease, hepatosplenomegaly, cerebral palsy.
Dx: IgM abs in the mother
Mx: check immunity, give mmr post-natally

Question 7

When and how should diabetes be tested for in pregnant women with a risk factor for diabetes?

Answer 7

OGTT at 24-28wks.