Medical Probs in Pregnancy

Question 1

Which AED are safe in pregnancy

What should women also take?

Answer 1

lamotrigine
levetiracetam

folic acid 5MG!!

Question 2

Diabetics complications

Answer 2

retinal and renal screen (refer is eGFR <45/abnormal creatinine/A:CR >30)
stop ACEI, ARBs, statins

FOLIC ACID 5MG

Question 3

Hypothyroidism and pregnant

Answer 3

increase thyroxine dose by 25mcg at + test
repeat TFTs every trimester (!2 weeks)

NO radioactive iodine

Question 4

what if I’m on ACEI for HT and I become pregnant

Answer 4

stop it and change to labetolol
(or methyldopa, nifedipine)
target 140/90

Question 5

name the two highest risk and contraindicated for pregnancy

Answer 5

Primary Pulmonary hypertension

Eisenmenger’s syndrome

Question 6

What do you give 5mg folic acid for

Answer 6

prevention of neural tube defects in higher risk patients eg.
diabetes
IBD
epilepsy 
sickle cell 
thalasseamia

Question 7

Three common features of antiphosphlipid syndrome

Answer 7

history of thrombosis
recurrent pregnancy loss
presence of antiphopholipid antibodies (aCL, LA)
stroke

Question 8

what’s the risk to mother/foetus in mother with autoimmune thrombocytopenia

Answer 8

mother: *risk of haemorrhage
foetus: low platelet count

Question 9

What is Von Willebrand factor required for

Answer 9

normal platelet activity

acts as a carrier for factor 8 activity

Question 10

Day 1 jaundice suggests what

Answer 10

haemolysis (rhesus/ABO incompatibility?)

sepsis??