Module 5 Flashcards

Question

What are coagulapathies

Answer 1

Impaired clotting ability which be be Inherited or Acquired through chronic disease, infection, heparin use, Vit K deficiency

Answer 2

* Require complete family history/ Detailed medical history * Pre-pregnancy counselling/Early pregnancy counselling * Referral to haematology specialists * Treatment as indicated

Answer 3

The presence of hypercoagulability that increases the risk of thrombosis.

Answer 4

Systemic lupus erythematosus (SLE) is when the body produces autoantibodies against its own connective tissue. Has some of the most serious consequences for pregnancy. The body is in a thrombophilic state. Goes through periods of remission and flares often triggered by infection, exposure to sunlight or oestrogen increase.

Answer 5

- No cure - Treatment aims to manage symptoms and prevent progression, survival rate to 15 years

Answer 6

- acute and chronic infection - nausea - vomiting - diarrhea - alopecia - photosensitivity - arthritis - ulcers - fatigues - myalgia - renal disease (>50%, 60% hypertension) - heart disease - hypertension - pericarditis - anaemia - thrombocytopenia - increases risk of miscarriage 40-80% (pregnancy loss in 20-30% of cases) - FDIU 8%

Answer 7

1/3 improve 1/3 stabilise 1/3 deteriorate

Answer 8

Women must fulfil at least one clinical and one laboratory feature at some time during the course of their disease Clinical features: - Recurrent pregnancy loss (MORE THAN 3 CONSIDER OBSTETRIC LUPUS ANTIBODY SCREEN) - fetal death - venous or arterial thrombosis - autoimmune thrombocytopenia - coombs positive - haemolytic anaemia Laboratory features: - ANA, ACA, LAC, Anti-Ro, Anti-La - Antiphospholipid antibodies are seen in 50% cases

Answer 9

Preconception care: - discuss complications - refer to obstetrician and rheumatologist - discuss conception during a period of remission - does not appear to affect fertility

Answer 10

- individual to the woman based on condition - antibody screening preconception - renal function testing - serial USS - low dose aspirin - patient education, preparation for hospitalisation, prem delivery, outcomes, - emotional support - obstetric involvement - assess proteinuria - treat flares with steroids - review medication - consider timing of delivery - steroids if preterm - CEFM, often can delivery vaginally - increased risk of flare postpartum - return to prepregnancy drug regime - lactation may be suppressed

Answer 11

- placental insufficiency - recurrent miscarriage - fetal loss - preeclampsia/ HELLP - preterm delivery - placental abruption

Answer 12

A disorder in which the immune system mistakenly attacks normal proteins in the blood. The condition is an acquired thrombophilia (clotting disorder), making women prone to thrombotic disorders.

Answer 13

Diagnosis on one clinical and one laboratory criteria Clinical criteria: - vascular thrombosis - one or more unexplained death of a normal fetus after 10 wks - one or more preterm birth before 34 weeks due to preeclampsia or placental insufficiency - three or more unexplained miscarriages before 10 wks. Laboratory criteria: - LA, aCL, IgG, IgM, Anti-B2 present on at least two occasions at least 12 weeks apart

Answer 14

- women with a history of SLE, thrombosis, recurrent miscarriage, severe IUGR, early onset pre-eclampsia, FDIU or prem delivery associated with IUGR should be offered screening for antiphospholipid antibodies, - discuss risks and pregnancy care - confirm antibody levels - advise aspirin, commence heparin, discontinue warfarin

Answer 15

- obstetrician involvement - regular growth USS, dating scan, - aspirin - monitor of signs of pre-eclampsia - blood tests - heparin. - CEFM - review by anaesthetist early - in labour adequate hydration, TED stockings, encourage mobility, active management, prompt suturing - Postpartum, increased risk of thrombosis, - admission to NICU if associated complications occur.

Answer 16

Inflammatory disease of the CNS that mostly affects women and those in the childbearing age group Characterised by plaques of tissue in the brain and spinal cord and a variety of classification types

Answer 17

- diplopia - vertigo - bladder incontinence - loss of vision - fatigue - muscular weakness

Answer 18

- optic neuritis - transverse myelitis - increase chance of relapses postnatally when physical and emotional stressors are greater

Answer 19

pregnancy has a protective benefit against relapses

Answer 20

- Treatment aimed at symptoms and improving everyday life rather than the disease itself, - acute episodes treated with high dose corticosteroids

Answer 21

- fertility is not affected - plan pregnancy during remission - review medications and discontinue where appropriate 3 months prior to conception - continuity of care - obstetric involvement

Answer 22

- Immunomodulatory agents are not recommended in pregnancy and lactation - Spinal epidural and GA can be used in MS - Exclusive breastfeeding and concomitant suppression of menses significantly reduces the risk of postpartum relapses in MS - Pregnancy does not affect the long term course or progression of the disease - Postnatal support should be available

Answer 23

- Characterised by increased serum bile acid and gestational pruritus

Answer 24

- stillbirth - preterm delivery - MSL - fetal distress - asphyxia - increased risk where serum levels are above 100umol

Answer 25

- symptomatic relief with topical ointments and lukewarm bath, - timing of delivery 36-40 wks - close fetal monitoring - CEFM in labour - Treatment using ursodeoxycholic acid - a naturally occurring bile acid derivative with an anti cholestatic effect in the human body.

Module 5 Flashcards

(50 cards)