Diferencia entre revisiones de «Comorbid diseases in pregnancy»

Revisión del 01:32 24 ago 2011

Treat all bacteriuria during pregnancy, even if pt is asymptomatic (reduces pyelo)
Cystitis
- Nitrofurantoin 100mg PO BID x3-10d is agent of choice
Pyelo
- Admit and tx with cephalosporin or amp + gent

Any pregnant diabetic presenting to ED who is ill appearing and/or w/ BS > 180 should be screened for DKA
Management guidelines for pregnant women w/ DKA are the same as for nonpregnant pts

Thyrotoxicosis in pregnancy may present as hyperemesis gravidarum
- All such pts should receive a screening TSH
Thyroid storm is treated similarly to non-pregnant pts

Coumadin is contraindicated during pregnancy
The highest daily risk of VTE is during the postpartum period
DVT
- 90% occur in the L leg
PE
- Most common cause of maternal death in the developed world
- If suspect and LE US shows DVT treat empirically for PE
- If suspect and LE US is negative obtain CT chest
  - Risk to fetus of childhood cancer from single scan is <1 case per million

Treatment is similar to non-pregnant pts except only use epinephrine if critically ill
- Concern about potential vasoconstriction of uteroplacental circulation

Maternal complications are most common during 3rd trimester and postpartum period:
- Cerebral vein thrombosis, PNA, sepsis, pyelo

Tintinalli

Authors:

@@ Línea 19: / Línea 19: @@
 ==Thromboembolism==
-*PE is the most common cause of maternal death in the developed world
+*Coumadin is contraindicated during pregnancy
 *The highest daily risk of VTE is during the postpartum period
-*90% of DVTs occur in the L leg
+*DVT
+**90% occur in the L leg
+*PE
+**Most common cause of maternal death in the developed world
+**If suspect and LE US shows DVT treat empirically for PE
+**If suspect and LE US is negative obtain CT chest
+***Risk to fetus of childhood cancer from single scan is <1 case per million
 ==Asthma Exacerbation==