Maternal Illness In Pregnancy

Question 1

Hyperthyroidism

Answer 1

Can be difficult to diagnose, tachycardia, heat intolerance and cardiac flow murmurs also occur in pregnancy
High levels of TS antibodies can cross placenta = fetal thyrotoxicosis
Sx: AF, abdo pain, vomiting, diarrhoea, psychosis
Complications: higher risk of pre eclampsia, miscarriage, preterm labour + LBW

Question 2

Obesity + pregnancy

Answer 2

Pre-conception advice: weight loss, 5mg folic acid, screen DM
In pregnancy: mech + pharmaceutical prophylaxis, 10 mg vit D, referral to obstetric anaesthetist
High risk PPH: actively managed 3rd stage is routine

Question 3

Gestational DM

Answer 3

2hr plasma venous glucose > 7.8

35-60% chance of developing T2DM in next 10-15 yrs

Question 4

Risk factors for gestational DM

Answer 4

High BMI
Prev macrosomic baby
Prev GDM
Fhx DM
Ethnicity

Question 5

Pre eclampsia

Answer 5

Normal urine protein

Question 6

BM aims

Answer 6

Before meal:

Question 7

Risks of DM in pregnancy

Answer 7

Neonatal hypoglycaemia
Pre-eclampsia 
Preterm labour
Polyhydramnios 
Macrosomia + shoulder dystocia