pregnancy

Chronic hypertension in pregnancy v/s pregnancy induced hypertension

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Chronic hypertension in pregnancy v/s pregnancy induced hypertension Chronic Hypertension in Pregnancy Pregnancy Induced Hypertension Means a hypertensive female has conceived Normotensive patient conceived & due to placental pathology @20 weeks, her BP ↑ Past H/O hypertension present No past H/O hypertension ↑ in B/P will be seen before 20 weeks ↑ in BP is […]

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Antihypertensives for chronic hypertension in pregnancy

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Antihypertensives for chronic hypertension in pregnancy For PIH/PE-1st choice- Labetalol Chronic HT in Pregnancy-Labetalol or α-Methyl Dopa HT Crisis-I/V Labetalol, I/V Hydralazine Safe Antihypertensive: Labetalol Alpha-methyldopa (safest) Nitroglycerine Calcium channel blockers – nifedipine Hydralazine Sodium nitroprusside (last resort) Beta Blockers Contraindicated during pregnancy: ACE inhibitors – like enalapril, captopril Angiotensin receptor blockers-Losartan Diuretics Atenolol Diazoxide

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Contraception of choice in heart disease

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Contraception of choice in heart disease 1. Temporary Methods → IUCD (earlier IUCD was not recommended but now WHO recommends its use); progesterone only pills, implants or injection, barrier contraceptives (condoms). 2. Permanent Methods → If the heart is not well-compensated, the patient’s husband is advised for vasectomy. → If heart is well-compensated-tubal sterilization can

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Clark’s Classification of Heart disease in pregnancy

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Clark’s Classification of Heart disease in pregnancy Group 1= ASD, VSD, PDA (congenital heart diseases), Any disease involving pulmonary and tricuspid valve & Bioprosthetic valve replacement. Maternal mortality <1% Group 2= Maternal mortality 15-25 % Group 3= Maternal mortality 25-50 % → Pulmonary hypertension -primary or secondary, an example of secondary being -Eisenmenger syndrome →

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Anticoagulant of choice in pregnancy

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Anticoagulant of choice in pregnancy During pregnancy, the choice of anticoagulant depends on period of gestation. Warfarin Heparin Advantage Strong anticoagulant Cannot cross the placenta Disadvantage Can cross the placenta and lead to Chondrodysplasia in fetus Weak anticoagulant     Period of Gestation Anticoagulant of choice ≤ 12 weeks Heparin 12 – 36 weeks Warfarin

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