Mohammad Pregnancy Planning

Which hormone rises during pregnancy and is produced by the placenta to maintain the corpus luteum?

Human chorionic gonadotropin (hCG).

What is the role of progesterone during pregnancy?

role of estrogen?

Maintains the uterine lining and prepares the breasts for milk production.

Promotes uterine growth and mammary gland development.

How much weight gain may occur during the first trimester?

weekly weight gain during the second and third trimesters?

1-5 lb or no weight gain.

½-1 lb per week.

What health conditions should be screened for before pregnancy?

Hypertension, diabetes, thyroid disorders, and depression.

When should folic acid supplementation begin before conception?

At least 1 month before conception.

What lifestyle factors should be addressed before pregnancy?

Optimal BMI, smoking cessation, and limiting alcohol.

When does GFR begin increasing during pregnancy?

During the first trimester.

What are the three major PLLR (Pregnancy and Lactation Labeling Rule) labeling sections?

Pregnancy, lactation, and female/male reproductive potential.

Which anticoagulant is a common contraindicated teratogenic medication?

antiseizure medication?

antimetabolite (cancer)?

GLP-1 medications?

SGLT2 inhibitors (diabetes)?

Warfarin.

Valproic acid.

Methotrexate.

Semaglutide, tirzepatide, and liraglutide.

Empagliflozin and dapagliflozin.

What is the key principle when a medication has potential teratogenic risk but may be necessary?

Use careful risk-benefit analysis and shared decision-making.

These medications have potential teratogenic risk but may be necessary...

Which mood stabilizer may require individualized pregnancy decision-making?

antiseizure medication?

antiemetic?

Lithium.

Carbamazepine.

Ondansetron.

What is the BP diagnostic threshold for hypertension in pregnancy?

severe hypertension in pregnancy?

How many BP measurements are required to diagnose hypertension in pregnancy?

SBP ≥140 mmHg and/or DBP ≥90 mmHg.

SBP ≥160 mmHg and/or DBP ≥110 mmHg.

Two or more measurements at least 4 hours apart.

What is chronic hypertension in pregnancy?

gestational hypertension?

preeclampsia?

eclampsia?

Hypertension present before pregnancy or developing before 20 weeks of gestation.

Hypertension developing after 20 weeks without proteinuria or other preeclampsia signs.

Hypertension with proteinuria or end-organ damage after gestational hypertension develops.

Seizures occurring with preeclampsia.

Besides proteinuria, what are severe features of preeclampsia?

Thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, new-onset headache

What medication is recommended to prevent progression to eclampsia?

Intravenous magnesium sulfate (decreases CNS/neuromuscular excitability, which prevents seizures)

Why can pregnancy lead to preeclampsia?

The mother's arteries remodel to become wider to provide the placenta with enough blood.

Abnormal remodeling → placental ischemia → release of antiangiogenic/inflammatory factors → maternal endothelial dysfunction → vasoconstriction, hypertension, and end-organ damage.

What is HELLP syndrome?

symptoms?

A severe form of preeclampsia involving red blood cell damage and impaired clotting.

HELLP = Hemolysis (breakdown of red blood cells), Elevated Liver enzymes, and Low Platelet count.

Abdominal pain and bleeding in the liver.

Why is aspirin prophylaxis given to high-risk patients?

Aspirin reduces abnormal platelet activation and improves placental blood flow.

What are risk factors for preeclampsia?

Prior preeclampsia, multifetal pregnancy, chronic hypertension, kidney disease (causes hypertension), or diabetes (chronic hyperglycemia → endothelial/vascular damage).

First pregnancy, BMI >30, family history, age ≥35, IVF, and certain pregnancy complications.

Which medications are first-line options for hypertension in pregnancy?

urgent severe hypertension in pregnancy?

Labetalol, nifedipine extended release, and methyldopa.

IV labetalol, IV hydralazine, or immediate-release oral nifedipine.

What is the normal serum creatinine range for women?

creatinine clearance range?

0.6-1.1 mg/dL.

88-128 mL/min.