Pulmonary Oedema Increased perinatal mortality Eclampsia Fitting/seizure secondary to pre-eclampsia Complications Abruption rupture Pulmonary oedema Retinal detachment Cerebral haemorrhage Maternal Management Basic resus BP controlled with IV hydralazine or IV magnesium sulphate labetolol IV diazepam Observe for 24 hrs Ectopic Pregnancy Pregnancy implanted outside of uterine cavity Presents with Abdo pain and bleeding Risk factors PID IVF Tubal Surgery Endometriosis Peritonitis or pelvic surgery Mini-pill IUCD Management Surgical Medical Salpingectomy Methotrexate (IM or Local) Salpinotomy Diabetes in pregnancy Pre-existing Diabetes Need increased insulin doses Acceleration of DM complications Increased risk of hypos Increased risk of DKA Complications Miscarrage poor control – Fetal congenital abnormality if poor control at conception – Proteinuric hypertension increased risk if pre-existent HTN or nephropathy – Macrosomia increased insulin (anabolic) – Soulder dystocia due to macrosomia – Polyhydramnios, IUD, birth fetal polyuria – UTI or candida glycosuria – Management MDT Increased insulin dose Dietary advice Regular fundoscopy Folic acid preconception Anomaly screening HbA1c monitoring Growth Gestational Diabetes
Pulmonary Oedema Increased perinatal mortality Eclampsia Fitting/seizure secondary to pre-eclampsia Complications Abruption Pulmonary oedema Cerebral haemorrhage rupture Retinal detachment Maternal Management Basic resus IV magnesium sulphate IV diazepam BP controlled with IV hydralazine or labetolol Observe for 24 hrs Ectopic Pregnancy Pregnancy implanted outside of uterine cavity Presents with Abdo pain and bleeding Risk factors PID Tubal Surgery Peritonitis or pelvic surgery IUCD IVF Endometriosis Mini-pill Management Surgical Salpingectomy Salpinotomy Medical Methotrexate (IM or Local) Diabetes in pregnancy Pre-existing Diabetes Need increased insulin doses Increased risk of hypos Acceleration of DM complications Increased risk of DKA Complications Miscarrage – poor control Fetal congenital abnormality – if poor control at conception Proteinuric hypertension – increased risk if pre-existent HTN or nephropathy Macrosomia – increased insulin (anabolic) Soulder dystocia – due to macrosomia Polyhydramnios, IUD, birth – fetal polyuria UTI or candida – glycosuria Management MDT Dietary advice Folic acid preconception HbA1c monitoring Increased insulin dose Regular fundoscopy Anomaly screening Growth Gestational Diabetes
OG-Revision-Notes.docx