Pregnant pts

Question 1

Fetal organ development, length and weight progress in a 40 week pregnancy

Answer 1

around week 20 there is rapid increases in weight/length

Question 2

endocrine changes in pregnancy

Answer 2

multiple hormonal changes (estrogen, progesterone, etc.)

Question 3

CV changes in pregnancy

Answer 3

increased CO (20-30%), HR
sometimes flow murmurs present

Question 4

hematologic changes in pregnancy

Answer 4

increased BV (30%)

Question 5

Respiratory changes in pregnancy

Answer 5

Increased rate of respiration

Question 6

levels of a full term pregnanc y

Answer 6

Question 7

spontaneous abortions

Answer 7

15% chance in first trimester, related to stress/ bacteremia

Question 8

ectopic pregnancy

Answer 8

implantation of fertilized oocyte in fallopian tube, pain and bleeding seen

Question 9

Pre-eclampsia and Eclampsia

Answer 9

Pre: HTN and proteinuria

eclampsia: malignant HTN, seizures, encephalopathy, condition in which high blood pressure and proteinuria lead to encephalopathy, coma, miscarriage and death

Question 10

Hormonal changes can either cause

Answer 10

Hormonal changes can either cause hypertension or syncope

Question 11

HTN monitored for?

Answer 11

eclampsia

Question 12

syncope in pregnant pts

Answer 12

Syncope can lead to traumatic injury; prodromal symptoms should be addressed by assuming a prone position

Question 13

anemia in pregnancy

Answer 13

can occur secondary to hematologic demands

Question 14

CVD in pregnancy

Answer 14

can be exacerbated in response to increased demands

Question 15

perio in pregnancy

Answer 15

perio dx could be exacerbated
Pregnancy Gingivitis and Exacerbated Periodontitis Exacerbated by:
- Lack of attention to Oral Hygiene
- Increased systemic fluid levels & capillary fragility from increased progesterone and estrogen
- Increased anaerobic bacterial plaque counts

Question 16

oral granulomatous pregnancy complication

Answer 16

May cause a granulomatous reaction with a more significant vascular component

Question 17

Pyogenic granuloma/ Epulis gravidarum/ Pregnancy Tumor

Answer 17

• not an actual granuloma as there is proliferation of vascular tissues as well proliferation of fibrous tissue
• forms submucosally and takes the shape a nodular growth
• Thought to be an exacerbated
  esponse to plaque and bacteria precipitated by the changes in hormonal levels

Question 18

pyogenic granuloma tx options

Answer 18

• variable
  *conservative management is an option
• May resolve post-partum
• Gentle curettage with electocautery
• Excision to the periosteum and removal of calculus and plaque

Question 19

Dental Evaluation in Pregnancy in each trimester

Answer 19

Question 20

specific guidelines for pregnant dental care
when to prohpy?
elective care?
when to restore?

Answer 20

Question 21

radiographs in pregnancy?

Answer 21

Only when there is an emergency that threatens the health of the mother and child i.e. abcess
primary beam not directed to child bearing area

Question 22

Rx in pregnant pts?
generally approved?
contraindicated? caveat?
absolutely contra?

Answer 22

low dose ASA is now frequently prescribed BUT only in low doses

Question 23

what analgesic can be used in all trimesters?

Answer 23

Acetaminophen (tylenol)
Aspirin, IBF, and naproxen are avoided in 1/3 trimesters

Question 24

what Abx is avoided in pregnancy

Answer 24

tetracycline

Question 25

can LA with epi bes used in pregnant pts?

Answer 25

yes

Question 26

NO use with pregnant pts

Answer 26

used at lower levels

Question 27

can these be used with pregnancy

Answer 27

yes

Question 28

gestational diabetes
* In some instances, it may also be?
* gestational diabetics are at higher risk of developing?
* symptomatic?

Answer 28

• high blood sugar affecting pregnant women who have insufficient insulin production relative to metabolic needs
• In some instances, it may also be insulin resistance
• gestational diabetics are at higher risk of developing type 2 diabetes later in life
• Generally asymptomatic

Question 29

when does gestational diabetes present

Answer 29

midterm ~24-28 weeks

Question 30

gestational diabetes treatment

Answer 30

• daily blood sugar monitoring
• Special meal plans emphasizing a healthy diet
• exercise
• monitoring the baby
• daily blood glucose testing and insulin injections
• If the above conservative measures are not responsive and blood sugar remains high, medication is needed
• IM - Insulin
• PO - Metformin (preferred)