Maternal Medicine Flashcards
Respiratory Indications for ECMO
ARDS
Pneumonia (infectious/aspiration/interstitial)
Severe asthma
Thoracic trauma causing lung contusion
Alveolar or pulmonary haemorrhage
Severe inhalation injury
Air leak syndromes (bronchopleural fistula)
Acute airway obstruction
Lung transplant
Cardiac indications for ECMO
Acute MI
Myocarditis
Cardiac arrest
Post heart transplant
Post cardiotomy
Hypothermia with cardiac instability
Postpartum acute cardiomyopathy
Drug intoxication
Septic cardiomyopathy
Arrhythmic storm
Interventional cardiac procedures
When to consider ECMO
When estimated mortality is in excess of 50-80% despite optimal medical management
Complications of ECMO
Intracranial haemorrhage
DIC
HIT
Bleeding
Hypertrophic cardiomyopathy incidence
0.1-0.5% of women
Symptoms/signs of hypertrophic cardiomyopathy
Syncope
Chest pain
Ejection systolic murmur
Pan-systolic murmur
Heart failure
Arrhythmias
Treatment of hypertrophic cardiomyopathy in pregnancy
B-blockers
Incidence of sarcoidosis in pregnancy
1 in 2000
Sarcoidosis site involvement
Lungs (1st)
Skin (commonest extra-pulmonary)
Heart (50%)
Brain
Eyes
Joints
Liver (20% hepatomegaly)
Pulmonary sarcoidosis presents as
Interstitial lung disease with fibrosis 20%
Pulmonary hypertension
Skin manifestations of sarcoidosis
Granuloma (lupus pernio)
Erythema nodosum
Erythema multiforme
Nummular eczema
Rate of myocardial infiltration with sarcoidosis
2-7%
Rate of CNS involvement with sarcoidosis and commonest site
5-13%
Cranial nerves
Pathogenesis of sarcoidosis
Th1 cell mediated
TNF-a
Interferon-y
Influx of CD14 macrophages
Investigations for sarcoidosis
CXR/CT
broncheolar lavage
Transbronchial biopsy
Cardiac MRI
ECG/echo
MRI head
EMG for myopathy
