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Flashcards in Medical disorders in pregnancy Deck (67)
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1

what are the booking bloods

FBC and blood group and ABs
harm-globulins
infection screen - hep B, HIV, rubella, VDRL
RBG

2

when is the booking visit
dating USS
anomaly scan
monthly visits are till when
anti D (2)
fortnightly visits when
weekly visits till when

8-12 weeks
11-12 weeks
20 weeks
till 28 weeks
28 and 34 weeks
28-36 weeks
37 weeks - delivery

3

what should be checked/asked at every antenatal visit

document gestation
BP
urinalysis
SFH (FSH)
fetal kicks/heart

4

incidence of hypertension in pregnancy
PET
severe PET
eclampsia

10-15%
3-5%
5/1000
5/10000

5

what is chronic (essential) ht
what is gestational ht
what is pre eclampsia

HTN present at booking or <20 weeks

new HTN> 20 weeks with proteinuria

new htn >20 weeks and significant proteinuria

6

what can lead to an increased risk inPET

chronic hypertension in mothers
or gestational hypertension

7

hypertension has what effects on the kidneys during pregnancy

increased GFR
proteinuria
serum uric acid
cr/k/urea
oliguria/anuria
acute renal failure

8

hypertension has what effect on liver

epigastric/RUQ pain
abnormal liver enxymes
hepatic capsule rupture
HELP

9

what is HELP synd

type of pre eclampsia - haemolytic, elevated liver enzymes, low platelets

10

placental and hypertension

IUGR
placental abruption
intra uterine death

11

investigations for htn

u&es
serum urate
LFTs
FBC
coag screen
CTG
US

12

management at booking

if there are risk factors for pre eclampsia -> put on aspirin

13

management of htn

labetalol
methyldopa
nifedipine (if the other two fail)

14

what should be stopped in preg

ACE and ARBs

15

what should be used in severe hypertension

labetalol PO/IV
hydralzaine IV
nifedipine PO

16

target BP

<150/80-100
organ damage <140-90
if <140/90 consider reducing dose
if <130/90 reduce dose

17

effects of hypertension on pregnancy and management of that

gestational htn
PET
eclampsia

monster BP, bloods, protein

18

planning of delivery in htn

vaginal
deliver at 37 weeks if PET

19

effects of pregnancy on DM

poorer control
deterioration of renal function
deterioration of ophthalmic disease
gestational DM

20

effects of medical condition on pregnancy

miscarriage
fetal malformations cardiac/NTD/caudal regression syndrome
IUGR/macrosomia
unexplained IUD
PET

21

medications in DM

diet
metaformin
insulin

22

planning of delivery in DM

vaginal
induce labour at 37-38 weeks

23

what does having diabetes lead to in the baby

fetal hyperinsulinaemia which leads to increased fetal growth

24

what 4 things does increased fetal growth lead to and whats a risk for each one

fetal macrosomia - risk of birth injury/shoulder dystonia

polyuria/polyhydramnios - risk of preterm labour/malpresentation/cord prolapse

increased oxygen demands/polycytheamia - risk of unexplained term stillbirth

neonatal hypoglycaemia - risk of cerebral palsy

25

risk factors for gestations DM

previous GDM
FH - one first degree relative or two second degree relatives
poor obstetric history
significant glycosuria
polyhydramnios
macrocosmic infant in this pregnancy
PCOS
weight>100kn or BMI >30
south asian, muddle eastern or african origin

26

BM target
HBA1C target
retinal screening when

4-6
<5%
every trimester

27

growth scans in DM
monitoring for what
elective delivery

serial growth scans at 28, 32, 36 weeks

PET

37-38 weeks in pre existing DM
38 weeks in GDM on insulin, may be 41 weeks if GDM on diet with normal Bfs and fetal growth

28

neonatal in DM

surveillance at delivery monitor BMs to ensure no neonatal hypoglycaemia

29

post natal management for mum in DM

return to pre pregnancy insulin/oral HG regime
GDM: stop treatment and monitor BM for 48 hours to ensure return to normal and no persistence

30

macrosmonia can lead to what

increased risk of birth injury/shoulder dystocia
obstetric litigation major cause
LSCS recommended in DM where macrosomia and EFW>4000g