6.2 Maternal Medicine

Question 1

What are some physiological changes to the CVS and blood in pregnancy?

Answer 1

Increased plasma volume, CO, SV and HR
Decreased serum albumin and serum colloid osmotic pressure
Increased coagulation factors
Compression of IVC by uterus

Question 2

What physiological changes occur to the kidney in pregnancy?

Answer 2

Increased renal blood flow

Increased GFR

Question 3

What physiological changes occur in the lung as a result of pregnancy?

Answer 3

Increase in tidal volume

Question 4

What physiological changes occur to the stomach and intestines as a result of pregnancy?

Answer 4

Nausea and vomiting
Delayed gastric emptying
Prolonged small bowel transit time - constipation
Gastrointestinal reflux

Question 5

What is normal weight gain in pregnancy?

Answer 5

20-30lbs

Question 6

What are some signs of pre eclampsia?

Answer 6

New onset raised BP grater than 140/90
Proteinuria (more than +1)
More than 20 weeks pregnant

Question 7

What clinical assessments may be made in pre eclampsia?

Answer 7

Examine optic fundi

Examine tendon reflexes - hyper reflexia?

Question 8

What causes gestational diabetes?

Answer 8

Insulin resistance

Question 9

How can pre eclampsia be treated?

Answer 9

Delivery

Can give a low dose of aspirin from 12 weeks to prevent

Question 10

What consequences are associated with gestational diabetes?

Answer 10

Macrosomia
Stillbirth
Neonatal hypoglycaemia

Question 11

Name some high risk factors for pre eclampsia

Answer 11

Hypertension in previous pregnancy 
Chronic kidney disease 
Autoimmune disease eg systemic lupus 
Antiphospholipid syndrome 
Type 1 or 2 diabetes 
Chronic hypertension

Question 12

Name some moderate risk factors of pre eclampsia

Answer 12

First pregnancy 
Aged 40 or over
Pregnancy interval greater than 10 years
BMI >35 
Family history 
Multiple pregnancy