Medical complications in pregnancy and post partum Flashcards
indicators of decreased renal function
decreased GFR
proteinuria
increased uric acid
increased CK/K/urea
kidney produces increased renin which acts on aldosterone II. What are the actions of aldosterone II
vasoconstrictor
increases aldosterone release from renal cortex - increases blood volume
these both lead to hypertension
hepatic complication of pregnancy
hepatic capsule rupture HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)
medication used for pre-eclampsia
- labetalol
- methyldopa
- nifedipine
medications used for severe hypertension in pregnancy
labetalol (oral or IV)
hydralazine (IV)
nifedipine (oral)
when should delivery occur in pre-eclampsia
37 weeks
medication used for VTE in pregnancy
LMWH
if suspected DVT, what is first line investigation in pregnancy
duplex ultrasound of lower limb
treatment for PE/DVT in pregnancy
therapeutic LMWH heparin - treat first
why can heparin be used in pregnancy
doesn’t cross placenta - safe for foetus
SE of heparin
haemorrhage
hypersensitivity
allergy at injection site heparin induced thrombocytopenia
osteopenia
investigations in suspected PE in pregnancy
ABGs
ECG
chest x ray - if normal, duplex Dopplers
if abnormal - CTPA
is warfarin ok in breastfeeding
yes
physiological change on ABGs due to pregnancy
respiratory alkalosis
what medication should be given to those who are epileptic and wish to start a family
folic acid
vit K from 36 weeks if taking hepatic enzyme inducing anticonvulsant
