Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Reproduction > Maternal Complications > Flashcards

Maternal Complications Flashcards

(53 cards)

Start Studying
1
Q

What is target BP in pregnancy?

A

<150/80-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is pregnancy induced hypertension (PIH)/gestational hypertension?

A

Hypertension developing over 20 weeks gestation, without proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is pre-eclampsia?

A

Pregnancy induced hypertension with associated organ damage, notably proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the pathophysiology of pre-eclampsia

A

Failure of invasion of maternal spiral arterioles by trophoblasts, causing reduced placental perfusion, resulting in an abnormal placenta

Hypo-perfused placenta releases pro-inflammatory proteins and so maternal vascular endothelial cells become dysfunctional, resulting in vasoconstriction

Vasoconstrictors take over and women’s BP is increased dramatically due to imbalance between vasodilators and vasoconstrictors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What percentage of the pregnant population is effected by pre-eclampsia?

A

5/10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give risk factors for pre-eclampsia

A

High

Preexisting HTN

Previous PET or gestational HTN

Existing autoimmune conditons, such as SLE and antiphospholipid syndrome

DM

CKD

Moderate

Age over 40

BMI>35

First pregnancy or more than 10 years since first pregnancy

FH

Multiple pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does pre-eclampsia present?

A

Headache

Blurred vision/papilloedema

RUQ/epigastric pain

N&V

Oedema

Brisk reflexes

Oliguria

Convulsions, if eclampsia development

Jauncide, due to HELLP syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the NICE guidelines for PET diagnosis?

A

BP above 140/90 plus any of

Proteinuria (1+ more on dipstick)

Organ dysfunction (HELLP, U&E dysfunction)

Placental dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What investigations are used for pre-eclampsia diagnosis?

A

Frequent BP and protein urine checks/24 urinary protein

FBC

  • Thrombocytopenia,
  • Anaemia

LFT

  • Elevated liver enzymes
  • Elevated bilirubin

U&E

  • Increased urea and creatinine

US

  • IUGR
  • Oligohydramnios

Group and save, if delivery thought to be likely

PIGF (placental growth factor)

  • Low in PET
  • Assess during 20-35 weeks to rule out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give maternal complications of pre-eclampsia

A

Eclampsia/seizures

Severe hypertension, causing cerebral haemorrhage and stroke

HELLP syndrome

  • Haemolysis
  • Elevated liver enzymes
  • Low platelets

DIC

Renal and Hepatic failure

Pulmonary oedema and cardiac failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give foetal complications of pre-eclampsia

A

Intrauterine growth restriction

Intrauterine death

Iatrogenic preterm delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the prophylactic management of pre-eclampsia?

A

75mg aspirin daily from 12 weeks gestation until birth to women with a single high risk factor or 2 or more moderate risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management of pre-eclampsia?

A

BP monitoring at least every 48 hours

US, doppler and aminocentesis monitoring of fetus every 2 weeks

IV labetalol

Planned early delivery with corticosteroids for fetal lung maturity

Fluid restriction during labour

IV magnesium sulphate within 24 hours of labour and 24 hours after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is delivery reccomended in PET?

A

Delivery within 24-48 hours in those women who has pre-eclampsia with mild or moderate hypertension after 37 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is used in PET instead of labetalol if patient is asthmatic?

A

Nifedipine, second line to labetalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management of eclampsia?

A

IV magnesium sulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How long can magnesium sulphate be given?

A

Continue for 24 hours after delivery or after last seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give side effect of magnesium sulphate

A

Respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is magnesium sulphate induced respiratory depression managed?

A

Calcium gluconate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How long after delivery does the risk of pre-eclampsia last?

A

6 weeks after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What should labetalol be switched to after delivery in PET?

A

Elanapril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can also reduce BP in induced labour?

Study These Flashcards
A

Epidural anaesthesia

23
Q

What is gestational diabetes?

Study These Flashcards
A

Diabetes/increased blood glucose occuring over 20 weeks gestation, that reverts to normal after delivery

24
Q

Describe the pathophysiology of gestational diabetes

Study These Flashcards
A

Insulin requirements of the mother increase

Human placental lactogen, Progesterone, Human chorionic gonadotrophin and cortisol from the placenta have anti-insulin action and so reduce insulin sensitivity

25
Describe the screening system for gestational diabetes
Women who've previously had gestational diabetes OGTT should be performed as soon as possible after booking and at 24-28 weeks if the first test is normal Women with any of the other risk factors should be offered an OGTT at 24-28 weeks
26
Give risk factors for gestational diabetes
BMI \>30 Previous macrosomic baby \> 4.5kg Previous GDM Increased age FH of diabetes Ethnic origin, asian or black carribean Polyhydramnios or macrosomia in current pregnancy Recurrent glycosuria in current pregnancy
27
When are women screened for gestational diabates?
Anyone with risk factors should be screened with an OGTT at 24-28 weeks gestation Women with previous gestational diabetes also have an OGTT soon after the booking clinic
28
Give the diagnostic thresholds for gestational diabetes
**5678** Fasting \>5.6mmoles/l 2 hour glucose \>7.8mmoles/l
29
Describe the management of patients with pre-existing diabetes
Weight loss 5mg folic acid/day from preconception to 12 weeks Aim for gestational diabetes targets Stop oral hypoglycaemic agents, apart from metformin, and commence insulin Retinopathy screening at booking and 28 weeks Adviced planned delivery at 37 weeks Detailed anomaly scan at 20 weeks
30
How is gestational diabetes managed?
Lifestyle advice Folic acid 5mg/day Regularly blood glucose monitoring Medication * Metformin * Insulin Oral glucose tolerance test 6-8 weeks postnatal Yearly check on HbA1C Retinal and renal assessment Provide glucagon injections and glucose solution Induce labour if concerns
31
What are the glucose targets in gestational diabetes?
Fasting 5.3mmoles/l 1 hour glucose 7.8mmoles/l 2 hour glucose 6.4mmoles/l
32
How often should patients measure blood glucose?
Daily fasting, pre-meal, 1 hour post meal and bedtime tests
33
When should insulin be used in management of gestational diabetes?
If at the time of diagnosis the fasting glucose level is \>= 7 mmol/l insulin should be started if the plasma glucose level is between 6-6.9 mmol/l, and there is evidence of complications such as macrosomia or hydramnios, insulin should be offered
34
When should metformin be used in management of gestational diabetes?
Fasting glucose \<7mmol/l, after lifestyle trial If glucose targets are not met within 1-2 weeks of altering diet/exercise metformin should be started
35
When is insulin used in gestational diabetes over metformin?
Metformin if fasting glucose \<7mmol/l, after lifestyle trial Insulin if fasting glucose \>7mmol/l
36
When and how much folic acid should be given in diabetic patients?
Folic acid 5 mg/day from pre-conception to 12 weeks gestation
37
Give fetal complications of gestational diabetes
Fetal congenital abnormalities Miscarriage Fetal macrosomia Polyhydramnios Operative delivery Shoulder dystocia, baby can get nerve palsy if damage Stillbirth
38
Give maternal complications of gestational diabetes
Pre-eclampsia Type 2 Diabetes * Nephropathy * Retinopathy * Hypoglycaemia Infection Perineal tear Haemorrhage
39
Give neonate complications of gestational diabetes
Impaired lung maturity and respiratory distress Neonatal hypoglycaemia Jaundice Polycythaemia Cardiomyopathy
40
Why is VTE risk increased in pregnancy?
Pregnancy is a hypercoagulable state to protect mother against bleeding post delivery * Increase in clotting factors (fibrinogen, vwf, platelets) * Decrease in natural anticoagulants (antithrombin III) * Increase in fibrinolysis Increased blood stasis * Progesterone * Enlarging uterus
41
Give risk factors for VTE in pregnancy
\>Age \>BMI FH Immobility Trauma Smoking Thrombophilia Parity over 3 Multiple pregnancy PET IVF pregnancy
42
How does VTE present?
Calf pain/tenderness Calf swelling Dyspnoea Acute chest pain Cough Tachycardia Hypoxia Pleural rub
43
When is VTE prophylaxis indicated in pregancy?
All women should have VTE risk assessment at booking 28 weeks if 3 risk factors First trimester/soon as possible if 4 or more, or if one significant risk factor
44
What anticoagulant is used in VTE prophylaxis?
LMWH * Dalteparin * Enoxaparin
45
How long is VTE prophylaxis continued in pregnancy?
6 weeks postpartum
46
What VTE investigation is not suitable in pregnancy?
D dimer, as pregnancy increases this in all women
47
How is PE/VTE managed in pregnancy?
LMWH, even before confirmed diagnosis with imaging
48
What trimester is obstetric cholestasis seen?
3rd
49
Give features of obstetric cholestasis
Pruritus, often in the palms and soles No rash, although skin changes may be seen due to scratching Raised bilirubin
50
How is obsteteic cholestasis managed?
Ursodeoxycholic acid is used for symptomatic relief Weekly liver function tests Vitamin K supplements Women are typically induced at 37 weeks
51
Give complications of obstetric cholestasis
Stillbirth
52
What trimester does acute fatty liver of pregnancy occur?
3rd, or the period immediately following delivery
53
Give features of acute fatty liver of pregnancy
Abdominal pain N&V Headache Jaundice Hypoglycaemia Severe disease may result in pre-eclampsia Elevated ALT HELLP

Reproduction (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions