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Flashcards in Complications in pregnancy Deck (11):
1

Aspirin

NICE recommend starting 75mg aspirin in women who are at risk of pre-eclampsia

2

Anaemia

<110 in trimester 1, <105 in 2 and 3 , <100 postpartum

Advice on maximising oral intake
Trial of oral iron first line
Refer is severe (<70) / > 34 weeks / failure to respond to trial of oral iron

Continue for 3 months after normal levels and until at least 6 weeks postpartum

3

Additional precautions

Hospital setting delivery
IV access
Group and save
Active management of 3rd stage
Plans for excess bleeding

4

Pre-eclampsia

Incidence 3-5%

Dx:
BP >140/90 on 2 occasions at least 4 hours apart
Proteinuria > 300mg / 24hours or 30nmol on spot test protein creatinine ratio

5

Pre-eclampsia RF

First pregnancy
Previous pre-eclampsia
> 40
BMI > 35
Multiple pregnancies
Pre-existing conditions

6

Pre-eclampsia

ADMISSION REQUIRED

Monitor FBC, LFTs, U&Es, urate, USS (associated with FGR)

Only cure is delivery of placenta - balance of risks and benefits

7

Management

Aim to keep BP < 160

Labetol (1st line), nifedipine (2nd line), hydralazine

Discharge when BP stabilised to < 140
2x weekly BP and urine, 1x weekly preeclampsia bloods, induction of labour arranged for 37 weeks

Fluid restrict due to risk of PO, magnesium sulphate infusions for seizure prevention

8

HELPP

Haemolysis
Elevated liver enzymes
Low platelets

Management similar but more supported. Replacement of blood and platelets as needed.

9

Fetal Growth Restriction

'Constitutional' or as part of spectrum of placental disease

Screening: customised SFH charts
RF: previous baby, pre-eclampsia / HTN, reduced fetal movements, maternal disease / smoking

Dx - USS (abdominal circumference, head measurements, femur length) - algorithm, assess placental function

10

Management of FGR

Exclude underlying cause e.g. infection, congenital
Monitoring
Timing of delivery - steroids if prem, monitor HR, monitor blood flow, caesarean often needed

11

APGAR Scoring

Appearance: blue / pale, acrocyanosis, pink
Pulse: absent, < 100, > 100
Grimace: absent, feeble, strong cry
Activity: none, some flexion, full movement
Respiration: absent, weak, strong

Take at 1 minute and 5 minutes
5 mins: >7 is normal and < 3 indicates neuro damage (NICU)