3: Medical problems in pregnancy Flashcards Preview

Reproduction Week 4 2018/19 > 3: Medical problems in pregnancy > Flashcards

Flashcards in 3: Medical problems in pregnancy Deck (50)
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1

Which groups of women are more likely to die during pregnancy?

Women with co-morbidities

Ethnic minority women

Overweight / obese women (cardiovascular disease risk i.e VTE)

2

What cardiovascular diseases are common causes of death in pregnancy?

Hypertension

Cardiac disease i.e MI

VTE i.e DVT, PE, stroke, MI

Diabetes

3

What cardiovascular changes occur in pregnancy?

Increased heart rate, contractility, stroke volume --> CO

Decreased BP and TPR

4

Why is the prevalence of heart disease in pregnancy increasing?

Increased maternal age

More obese women

More women with pre-existing or congenital heart disease

5

What is a major risk factor for ischaemic heart disease in women?

Pregnancy

:/

6

What innocent cardiovascular signs and symptoms are seen in pregnant women?

Innocent murmur

Palpitations

7

Which anticoagulant is teratogenic?

Warfarin

LMWH isn't, so swap it

8

Which cardiovascular disease is often fatal if carried into pregnancy?

Pulmonary hypertension

9

What is Eisenmenger's syndrome?

Right-to-left shunt caused by PH secondary to a congenital heart defect e.g VSD

10

Which

a) endocrine

b) genetic disorders are associated with congenital heart disease?

a) Diabetes

b) Marfan's syndrome (aortic root dilation -> regurg)

+ a million more

11

Palpitations occuring during pregnancy are usually ___.

benign

12

What cardiac investigations should be done for a woman presenting with palpitations?

ECG

If dodgy, do echo

13

Which endocrine diseases may cause palpitations in pregnant women?

Hyperthyroidism

Phaeochromocytoma

14

Which NYHA class of cardiovascular disease is a contraindication for pregnancy?

3+

make sure the woman is using contraception

15

What respiratory changes occur during pregnancy?

Increased oxygen consumption

Increased tidal volume BUT NOT respiratory rate

Decreased functional residual capacity (lungs are compressed by pregnancy)

16

What blood gas changes occur during pregnancy?

% O2 increases

% CO2 decreases

So blood pH increases

17

Palpitations is a common cardio complaint in pregnancy.

What is a common respiratory complaint?

SOB

18

Which chronic respiratory condition is often seen in pregnant women?

Asthma

19

Why do many pregnant women experience a deterioration in their asthma early in pregnancy?

Concerns re: medication effect on baby (steroids, inhalers)

so they stop using them and their asthma gets worse

20

What should women on long-term steroids be given during childbirth?

IV steroids e.g hydrocortisone

bc. they will have adrenal insufficiency

21

Can women continue on their inhalers during childbirth?

Yes

22

What is the most common direct cause of maternal death in pregnancy?

Venous thromboembolism

i.e DVT

23

Where exactly do DVTs tend to occur in pregnant women?

Left leg

Iliac / femoral vein

24

When in the course of pregnancy does DVT tend to occur?

Post-birth

25

Virchow's triad for venous thromboembolism includes epithelial damage, hypercoagulability and venous stasis.

How do pregnant women fulfill these factors?

Epithelial damage - rapid cardiovascular changes

Venous stasis - lying down a lot, especially in hospital

Hypercoagulability - some women have thrombophilia

26

Which type of drug is given as prophylaxis for DVT in pregnant women?

Anti-coagulant

NOT warfarin - LMWH

27

What congenital disease, causing hypercoagulability, causes DVT in pregnancy?

Thrombophilia

28

What LMWH is used for pregnant women in Tayside?

Dalteparin

29

What influences the dose of dalteparin given to pregnant women to prevent VTE?

Maternal weight

30

What investigation is used to diagnose DVT in pregnant women?

Duplex ultrasound

like a doppler for your leg