Pregnancy Complications Flashcards Preview

OBGYN Clerkship > Pregnancy Complications > Flashcards

Flashcards in Pregnancy Complications Deck (62)
Loading flashcards...
31

mono vs di zygotic twins

mono = 1 sperm and 1 egg --> idential DNA (no predisposing factors)

dizygotic = 2 sperm an 2 ova

32

dizygotic twins have increased prevelance in

africans, IVF, clomiphene citrate

33

What are complications of multiple gestations

PTL, placental previa, postpartum hemorrhage, preE, cord prolapse, malpresentation, GDM, incompetent cervix

34

Management for....
Siamese/conjoined twins
mono-mono- twins
vertex/vertex twins
vertex, non-vertex twins
non-vertex/non-vertex twins
triplets and above

Siamese/conjoined twins = C/S
mono-mono- twins = C/S
vertex/vertex twins = vaginal
vertex, non-vertex twins = vag or C/S
non-vertex/non-vertex twins = C/S
triplets and above = C/S +/- selective reduction

35

What is TTTS? what kind of twins are at risk for this?

unequal bloodflow in shared placenta of mono-di- twins thar results in one small/anemia twin and one large/polycythemic twin

36

What is the management of TTTS

serial US q2wks in all mono-di twins --> tx with serial amnioreduction in larger twin

37

What is severe n/v + intolerance of PO diet

hyperemesis gravidarum

38

What should you r/o in all pts with hyperemesis gravidarum

molar pregnancy (get b-hCG)

39

When does morning sickness typically resolve

week 16

40

seizure threshold lowered or inc when pregnant

lowered

41

What is the etiology of most seizures in pregnancy

inc epileptic medication metabolism, dec pt compliance, dec seizure threshold, hormonal changesz

42

what is the teratogenicty of anti-epileptic drugs

folate antagonism --> neural tube defects
epoxide generation --> fetal hydantoin syndrome (IUGR, craniofacial malformations, etc)

43

How is a seizure d/o mananged in pregancy

monotherapy with lowest dose of Rx
at 19-20 wks klook for congenital anomales w/ US
folate supplementation
vit K supp at 27 wks

44

What pre-ext maternal heart dz is high risk in preg

pulm HTN
Eisenmenger syndrome
severe MS or AS (wait 1 yr after correction to get pregers)
marfan syndrome

45

how is preg managed in pts with high risk heart dz

terminate preg = first line
basline EKG + medical stabilization
d/c teratogenic drugsa (ACEi/ARBs, diuretics, coumadin)
at delivery: early epidural, careful fluid monitorins, abx ppx for SBE (bac endocarditis)

46

Peripartum cardiomyopathy management

Dx with ECHO ( dilated heart with ECHO 34wks and medical management if < 34 wks

47

Pts with mild renal Dz are at risk for

preEclampsia and IUGR

48

Management of preg women with renal transplant

increase immunosuppressants (prednisone) dosage bc there is an inc risk of acute rejection in preg

49

GFR for
stage 1 CKD
stg 2
3
4
5 (ESRD)

stage 1 CKD = 90-100
stg 2 = 60-89
3 = 30-59
4 = 14-29
5 (ESRD) = < 15

50

Management of DVT in preg

heparin or lovenox (enoxapain)
**warfarin is CI

51

management of PE in preg

heparin or lovenox (enoxapain); t-PA if <3hrs

52

How is hyperthyroidism in pregnancy managed

screen for tyroid stimulating immunoglobulins (TSIs)
if elevated, give PTU and monitor fetus for goiter and IUGR

53

Treatment for thyroid storm in preg

Beta blockers

54

what is infanthyperthyroism/cause?.

maternal TSIs cross placenta and attack fetal thyroid gland

55

What are common pregnancy complications in women with lupus

inc risk preeclampsia
IUGR
spontaneous abortion

56

How is SLE managed in pregnancy

low dose aspirin, heparin, or corticosteroids for ppx

57

how to differentiate between lupus flare and pre eclampsia?

check complement levels (SLE will have dec C3-C5)

58

What is the management for a lupus flare in preg

high dose corticosteroids, cyclophosphamide is unresponsive

59

What is neonatal lupus syndrome

maternal Ag-Ab complex crosses placenta anf cause lupus in neonate
**baby can also have congenital heart block 2/2 anti-ro (SSA) cross placenta and attack fetal heart --> 3rd degree block

60

Fetal alcohol syndrome characteristics

abn facies, IUGR, MR, bad heart