pregnancy

Question 1

when during pregnancy to do dental work or surgery?

Answer 1

• urgent care only in the first trimester,
• second trimester - most ideal time for treatment
• third trimester can cause pre-term labor.

Question 2

if supine hypotension develops in pregnancy - what to do?

Answer 2

roll patient on the left side, it is secondary to compression of the vena cava.

Question 3

radiographs during pregnancy

Answer 3

use usual protective equipment as the dose is far below the 5 Gy quoted to cause problems.

Question 4

can you use nitrous?

Answer 4

no - may cause spontaneous abortion?
nitrous inactivates methionine synthetase.

Question 5

medications you can use during pregnancy and their restrictions?

Answer 5

• Local anesthetics - can use
  Tylenol- can use
• NSAIDs - avoid in third trimester, ibuprofen may close PDA
• ASA - NO - may cause intrauterine growth restriction, intracranial bleeds
• codeine and oxycodone - avoid in first trimester
• fentanyl ok
• benzos, barbiturates, propofol, nitrous oxide - either no or controversial
• antibiotics CAN USE - penicillin, augmentin, cephalosporins, azithromycin, erythromycin, clindamycin, nystatin, vancomycin, chlorhexidine
• antibiotics NOT USE gentamicin, metronidazole, tetracycline, fluconazole,
  page 462 in blue book

Question 6

preeclampsia soundbite, and medications used to manage in severe pre-eclampsia

Answer 6

pregnancy condition characterized by hypertension after 20 weeks caused by abnormal placental implantation and is accompanied by proteinuria or other maternal organ dysfunction
medications to manage: labetolol, hydralazine, nifedipine, and seizure prophylaxis with mag sulfate

Question 7

eclampsia soundbite and management

Answer 7

pregnancy condition, which is a form of severe preeclampsia with seizures and sometimes comas.
management - delivery of fetus, antihypertensives, labetolol, hydralazine, and nifedipine
mag sulfate

Question 8

HELLP syndrome soundbite

Answer 8

pregnancy syndrome characterized by hemolysis, elevated LFTs and low platelet counts.

Question 9

Gestation hypertension soundbite

Answer 9

pregnancy condition with SBP greater than 140, or diastolic greater than 90 without proteinuria or chronic hypertension
- can progress to to preeclampsia if proteinuria progresses.

Question 10

gestational diabetes soundbite

Answer 10

a pregnancy condition of glucose intolerance
do lifestyle changes first, maybe medication.