Week 4 part 2 Flashcards Preview

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Flashcards in Week 4 part 2 Deck (90)
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1

What are the effects of diabetes on pregnancy?

1. Miscarriage
2. Fetal malformations cardiac, neural tube, caudal regression syndrome
3. IUGR/macrosomia
4. Unexplained IUD
5. PET

2

mEDICATIONS for diabetse in pregnancy>

Diet, metformin, insulin

3

When should labour be induced with diabetes?

At 37-38 weeks

4

Diabetes causes fetal macrosomia - what risk does this have?

Shoulder dystocia

5

Diabetes causes polyuria, polyhydramnios - what risk does this have?

Preterm labout/malpesntation/cord prolase

6

Diabetes causes increased O2 demands and polycythaemia - what risk does this have?

Risk of unexplained term still birth

7

Diabetes causes neonatal hypoglycaemia - what risk does this have?

Risk of cerebral palsy

8

Is PCOS a risk factor for gestational diabetes mellitus?

Yes

9

In pregnancy with pre-existing DM when should labour be induced?

At 37-38 weeks

10

Major cause of obsetric litigation?

Macrosomia

11

What is LSCS recommended in DM where macrosomia and EFW greatr than 4000g?

Macrosomia

12

What fetal effect of DM causes fetal malpresentations and possible increased risk preterm labouir?

Polyhydramnios

13

What does hyperinsulinaema in fetus cause risk of?

CP

14

wHAT IS THE leading cause of maternal death?

VTE - venous thromboembolism

15

wHAT ARE medications for VTE in pregnancy?

LMWH

16

Is pregnancy pro-thrombotic?

Yes

17

Virchows triad in preganncy

Stasis - secondar to venous compression by pregnant uterus
Hypercoagulability - effects of pregnancy
Vascular damage - varicose veins

18

Evolutionary - why is pregnancy a pro-coaguable state?

To decrease risk of post partum haemorrhage

19

Pregnancy is a pro coaguable state - what factors are increased?

7,8,9,10,12 and fibrinogen, increased platelets

20

Pregnancy is a pro coguable state - what factors are decreased?

Factor 11 and antithrombin 3

21

Three risk factors for VTE (preexisting)?

Obesoty
greater than 35 years of age
Smoker

also parity >3, elective CS, FH, varicose veins, systemic infection, immoblity, PET, twins

22

In pregnancy, if four or more risk factors for VTE?

Prophylaxis in first trimester

23

3 risk factors for VTE in pregnancy?

Prophylaxis from 28 weeks

24

Postnatally, if any previous VTE, anyone requiring antenatal LMWH, high risk thrombophilia, low risk thrombophilia + FH - what is managed?

High riSK - at least 6 weeks [pstnatal prophylactic LMWH

25

With DVT - what investigation is NOT done in pregnancy?

D-dimer - do ultrasound instead and give therapeutic heparin - treat then see!

26

What is the therapeutic dose of LMWH in pregnancy?

1mg twice daily OR once daily - continue until 3 months after delibery ot 6 months after treatment

27

Why is heparin safe in pregnancy?

Doesnt cross placenta - no anticoagulation effect on fetus

28

Side effects of heparin in pregnancy?

Haemorrhage
Hypersensitiity
HIT - heparin induced thrombocytopenia
Osteopenia

29

In PE in pregnancy what do u give before investigating?

Heparin

30

What mght PE cause on CXR in pregnancy?1.

1. Atelectasis - collapse of lung
2. Effusion
3. Focal opacities
4. Regional oligaemia
5. Pulmonary oedema