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22 Cards in this Set
- Front
- Back
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Gestational diabetes incidence?
when is it screened? how screened? |
3-8 % pregnancys
24-28 wks - oral load glucose challenge >135 abnormal if abnormal due a 3 hr 100gm oral load |
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link between birth defects and increasing glycosylated HgBA1c
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There is a direct link between birth defects and increasing
glycosylated hemoglobin levels (HgBA1C) in the period of embryogenesis |
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What is diabetes classified under... which is for gestational diabetes?
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Whites classification w/ 2 classes for gestational diabetes (a1- "diet controlled", a2- insulin or oral med controlled")
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For previous gestational diabetes what is needed every trimester?
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1. renal- 24 hr. urine collections
2. cardiac EKG 3. ophthalmic - detailed eye exam 4. glycemic control Fetal- growth ultrasound every 2-4 wks |
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What weight is max before you force c-section?
If pt on medication for gestational diabetes what is hourly glucose monitoring? |
4250 grams
80-120 should be checked every hour |
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Maternal hyperthyroid evaluated by?
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Elevated free T4 and suppressed TSH use PTU and methimazole to treat
- watch out for thyroid storm which results with 25% mortality |
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Rheumatic heart disease mc? SLIDE 16
Primary pulmonary hypertension IN mother that wants to get pregnant?? |
Mitral stenosis
- is contraindication to pregnancy due to decompensation during pregnancy |
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What arrhythmias are most common seen during pregnancy?
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supraventricular tachycardia
- more worrisome for underlying cardiac disease (atrial fib/ flutter) |
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Delivery and immediate postpartum of cardiac prego?
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1. try vaginally unless there is obstetric indications and AB prophylaxis for endocarditis high rix
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When does treatment for Immune idiopathic thrmobocytopenia occur?
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Treatment
• Begun after platelets drop to 40,000 • Prednisone • Intravenous immunoglobulin if severe • Platelet transfusion • Splenectomy |
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Someone with DVT or PE look for? or 3 first trimester miscarriages or 2-3 trimester loss
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Anti-phospholipid syndrome
tx with heparin/low melecular weight heparin |
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ARF in pregnancy 3 types??
tx of those types |
Prerenal- seen with acute blood or fluid loss
• • Renal-usually preexisting disease or hypercoagulable state • Postrenal- rare, urologic obstructive lesions (kidney stones) tx- depends on pre,renal, or post pre- restore volume... renal- directed at preventing further damage (diuretics), postrenal- mechanics to remove obstruction |
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Nausea and vomiting incidence in pregnancy?
What are the people that are in trouble that puke too much called? |
60-80% complain during first 8-12 weeks
-symptomatic tx unless hyperemesis gravidarum 1% |
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Why do you get reflux esophagitis in pregnancy?
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1. increased progesterone relaxes sphincter
2. uterus increased size puts pressure 3. pH different |
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What is mendelson's syndrome? (acid aspiration syndrome)
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– Pregnant women at greater risk due to delayed gastric emptying and increased intraabdominal/intragastric pressure
– Can result in adult respiratory syndrome tx o2, prevention by not feeding during labor |
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Cholestasis of pregnancy.. increases risk of what?
sx? labs? |
meconium stained amniotic fluid and fetal demise
- itching w/o abdominal pain or rash - elevated bile acids |
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Difference between FATTY LIVER COMPARED TO PRE-ECLAMPSIA?
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FATTY LIVER OF PREGNANCY SHOWS WITH JAUNDICE
--> must terminate pregnancy |
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Superficial thrombophlebitis most common presentation?
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Most common in patients with varicose veins, obesity and little
physical activity |
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DVT found in which leg
tx? |
MC Left leg than the right
tx- anticoagulation (lovenox or UFH) |
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Tachy, SOB and pregnant?
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Pulmonary Embolism 70% DVT instigating factor
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Asthma tx of pregos
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• Mild intermitent-short acting inhaled beta agonist
• Mild persistent-low dose inhaled corticosteroid • Moderate persistent-daily inhaled corticosteroid combined with long acting inhaled beta agonist • Severe persistent- add systemic corticosteroids |
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if patient on anti-epileptics how much folic acid?
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Women on antiepileptics should be on anywhere from 1 mg to 4 mg folic
acid depending on which agent is used |
