Book of Medical Disorders in Pregnancy - Tintash

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11. Percutaneous transluminal angioplasty and stent placement during pregnancy. Obstet Gynecol. 106: 2005; 1162-1164. 12. Acute myocardial infarction in pregnancy: A United States populationbased study. Circulation. 113: 2006; 1564-1571. 13. Recurrence rates of arrhythmias during pregnancy in women with previous tachyarrhythmia and impact on fetal and neonatal outcomes. Am J Cardiol. 97: 2006; 1206-1212. 14. A cathepsin-D cleaved 16-kD form of prolactin mediates postpartum cardiomyopathy. Cell. 128: 2007; 589- 600. 87
Chapter No: 6 RENAL DISEASE IN PREGNANCY Fig6.1: Shows locations of kidneys and its relations with pancreas In pregnancy, physiological and anatomical changes in the urinary tract occur in response to a variety of factors. Knowledge of these changes is important for the understanding and management of the various disease entities that occur in the genitourinary system of the pregnant patient. Major physiological changes in the urinary tract in pregnancy - The increased b100d flow to the kidney during pregnancy, which approximates 50% above normal, begins early in pregnancy and by the second month is well established. As a result of the increased renal blood flow both in the erect and supine positions, changes occur in many of the fundamental physiological functions of the kidney, they include. Glomerular filtration rate 88 (GFR) is increased by 50% by the second month and increases steadily to term. BUN (b blood urea nitrogen) is reduced to 8.5 = 1.5 mg, %. The normal level in the non pregnant state is 1.3 + 3 mg %. serum creatinine is reduced to 0.46 = 0.6 mg%. The normal level in the non pregnant state is 0.767 1: 0.17 mg %. clearance studies are not particularly reliable in pregnancy (i.e. inulin etc.). However, creatinine clearance parallels roughly to the glomerular filtration rate, so it is increased in pregnancy. These changes in GFR, BUN and serum creatinine may lead to a false assumption that the diseased kidney in pregnancy is functioning satisfactorily, other changes which are important to the kidney's function should be noted but are less important clinically; plasma aldosterone level is increased; and sodium reabsorption is increased. These physiological alterations may be necessary for the maintenance of fluid homeostasis and blood pressure. Glucosuria and lactosuria may occur in the normal pregnant patient due to failure of the kidney to increase its resorptive power". Anatomical changes in the renal tract: From early pregnancy and throughout the puerperium, the renal collecting system is dilated (physiological hydronephrosis); peristalsis is decreased. These changes are clearly established as early as the second trimester. Dilatation is usually greater on the right side. The cause of the dilatation is unknown, but it is assumed to be largely hormonal, although mechanical obstruction of the
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MEDICAL DISORDERS IN PREGNANCY M. S
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PREFACE Almost all medical disorder
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Dedication This manuscript is dedic
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Uri. Elkayam MD Professor of Cardio
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Chapter No: 1 Anaemia in pregnancy:
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performance. Tiredness, listlessnes
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pregnancy and labour. The monthly b
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Fig 1.3: Shows developmental stages
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Prophylactic this includes routine
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granulocytes and thrombocyte is als
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or because the hemoglobin A is repl
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iron. Decrease in the number of gra
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Labor/delivery: Expedite for normal
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Risk factors: The risk of GDM incre
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to a large extent on the measure of
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vomiting, or through intercurrent i
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largely related to the problems of
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femoral epiphyses can help in asses
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in a randomized design the efficacy
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of the previous day’s dose of ins
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women with vascular disease are awa
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Chapter No 3 THYROID DISEASE IN PRE
Page 46 and 47: such as phenobarbitone 30 mg given
Page 48 and 49: REFERENCES: 1. Hawe, P. and Francis
Page 50 and 51: Incidence - Its incidence varies ac
Page 52 and 53: cerning the disturbance in the Reni
Page 54 and 55: Renal function: In normal pregnant
Page 56 and 57: severe pre eclampsia and eclampsia
Page 58 and 59: Epipastic pain: It is also a late s
Page 60 and 61: arely occurs. However, if pregnancy
Page 62 and 63: differentiating between chronic hyp
Page 64 and 65: fetuses. Recent studies indicate th
Page 66 and 67: to procrastinate all available meth
Page 68 and 69: cases are said to occur up to 1 wee
Page 70 and 71: has been carried out. There can be
Page 72 and 73: intensive care room for the next 48
Page 74 and 75: Severe pre eclampsia at or remote f
Page 76 and 77: Chapter No: 5 HEART DISEASE IN PREG
Page 78 and 79: pregnancy. The increase in volume i
Page 80 and 81: Fourth Heart sound - This is rarely
Page 82 and 83: Class III - With cardiac disease pr
Page 84 and 85: differentiate from hemodynamically
Page 86 and 87: dominant). Jervell + Lange Nielson
Page 88 and 89: striking of which is stippling seen
Page 90 and 91: increase venous pressure and burden
Page 92 and 93: determine whether she will be safe
Page 94 and 95: supplemental 02. Fetal surveillance
Page 98 and 99: ureter at the pelvic brim may play
Page 100 and 101: Fig6.3: Shows location of kidney in
Page 102 and 103: A clear cut history of streptococca
Page 104 and 105: (a) Polycystic renal disease - Fort
Page 106 and 107: with patients in this category. In
Page 108 and 109: 2. Beard, R.W.and Roberts, A.P. (19
Page 110 and 111: increases slightly. Arterial blood
Page 112 and 113: scan, 0.004 Gy; pulmonary angiograp
Page 114 and 115: CD4 + cell count (200/ml) should re
Page 116 and 117: embark upon a pregnancy. Severe air
Page 118 and 119: Chapter No: 8 LIVER DISEASE IN PREG
Page 120 and 121: owel, but conjugated bilirubin is n
Page 122 and 123: Hepatic causes - Viral hepatitis bo
Page 124 and 125: Immunoprophylaxis at birth followed
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Page 128 and 129: curs in 60 to 70 percent of subsequ
Page 130 and 131: Chronic liver disease: An increased
Page 132 and 133: 22. Riely CA. Hepatic disease in pr
Page 134 and 135: ilirubin is transported across the
Page 136 and 137: when the titre is greater than 1: 3
Page 138 and 139: Induction of labour: When screening
Page 140 and 141: Blood brain barrier and bilirubin e
Page 142 and 143: place if the infant develops jaundi
Page 144 and 145: REFERENCES 1. UpToDate a. “Pathog
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of embolus formation is far less in
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Unfortunately this faculty is not a
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hours. The maximal effect takes 36
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may complain of constricting type o
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When the embolus is small and non f
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3. Sukal S, Geronemus R. "Deep Veno
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damage specific cells in the tissue
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is capable of breaking off and deve
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Chapter No: 12 PARASITIC INFECTIONS
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sporozoite stage. The main characte
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insect repellents and insecticide s
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is 2 tablets i.e. (400 mgs) thrice
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Cardiac failure resulting from seve
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dysmenorrhea, dysuria, and even obs
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Chapter No: 13 VIRAL DISEASES IN PR
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after exposure favors but does not
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Fig13.4: shows CMV infection rash o
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three quarters of HYH strains isola
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where 'T' stands for toxoplasmosis
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Chapter No: 14 Introduction: The dr
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hexacyanoferrate (II) 2H2O (Prussia
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Restricted indications: Anti lepros
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potential Teratogen and inhibits ma
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placental abruption, and intrauteri
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Inhalation of volatile organic comp
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Chapter No: 15 Pregnancy is a norma
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time periods during the pregnancy f
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y the maternal kidney in urine or b
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continues after the end of the uter
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Amniography - In this technique rad
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at the cranial end of the neural tu
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least maceration: placenta, lung, a
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fetal hydrops with monosomy X, or T
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cause progressive renal failure as
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9. Papageorgiou, E.A.; Karagrigorio
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position of the head. The student s
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centimeter ruler is placed alongsid
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echoes in B mode. The operator appl
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also affects depth resolution and t
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From twelve week onwards the bipari
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tract. Normal kidneys can easily be
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3.19, 1.29 and 1.30, respectively [
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iodinated contrast during pregnancy
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Only tiny amounts of iodinated or g
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intraperitoneal hemorrhage, or inju
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REFERENCE: 1. Stewart A, Webb J, Gi
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cardiac defects 181, 200 cardiac di
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gestational age 26, 31, 40, 165, 19
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monitoring, invasive 83-6 monosomy
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sensitization 124-5 sepsis 22, 95-6
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