Diferencia entre revisiones de «Comorbid diseases in pregnancy»
(Text replacement - "Category:OB/GYN" to "Category:OBGYN") |
(Text replacement - " pts" to " patients") |
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| Línea 8: | Línea 8: | ||
==[[DKA]]== | ==[[DKA]]== | ||
*Any pregnant diabetic presenting to ED who is ill appearing and/or w/ BS > 180 should be screened for DKA | *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 | *Management guidelines for pregnant women w/ DKA are the same as for nonpregnant patients | ||
==[[Hyperthyroidism]]== | ==[[Hyperthyroidism]]== | ||
*Thyrotoxicosis in pregnancy may present as hyperemesis gravidarum | *Thyrotoxicosis in pregnancy may present as hyperemesis gravidarum | ||
**All such | **All such patients should receive a screening TSH | ||
*Thyroid storm is treated similarly to non-pregnant | *Thyroid storm is treated similarly to non-pregnant patients | ||
==[[Hypertensive emergency]]== | ==[[Hypertensive emergency]]== | ||
| Línea 30: | Línea 30: | ||
==[[Asthma]] Exacerbation== | ==[[Asthma]] Exacerbation== | ||
*Treatment is similar to non-pregnant | *Treatment is similar to non-pregnant patients except only use epinephrine if critically ill | ||
**Concern about potential vasoconstriction of uteroplacental circulation | **Concern about potential vasoconstriction of uteroplacental circulation | ||
| Línea 38: | Línea 38: | ||
==[[Headache]]== | ==[[Headache]]== | ||
*Manage similar to non-pregnant | *Manage similar to non-pregnant patients except avoid NSAIDs | ||
==[[Seizure]]== | ==[[Seizure]]== | ||
Revisión del 16:50 21 jun 2016
UTI
- 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
DKA
- 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 patients
Hyperthyroidism
- Thyrotoxicosis in pregnancy may present as hyperemesis gravidarum
- All such patients should receive a screening TSH
- Thyroid storm is treated similarly to non-pregnant patients
Hypertensive emergency
- Labetalol is agent of choice
Thromboembolism
- 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
Asthma Exacerbation
- Treatment is similar to non-pregnant patients except only use epinephrine if critically ill
- Concern about potential vasoconstriction of uteroplacental circulation
Sickle Cell Disease
- Maternal complications are most common during 3rd trimester and postpartum period:
- Cerebral vein thrombosis, PNA, sepsis, pyelo
Headache
- Manage similar to non-pregnant patients except avoid NSAIDs
Seizure
- Manage similar to non-pregnant pt
- Aggressively treat status epilepticus (intubation)
See Also
References
Tintinalli