ANEMIA IN PREGNANCY : MCQS AND IMPORTANT MCQS By DR MARIA RAFI

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  1.  A 30-year-old pregnant female is undergoing routine blood tests . Pregnancy is associated with an increase in which of the following? A) Mean Cell Hemoglobin Concentration (MCHC) B) Serum ferritin concentration C) Hematocrit D) Total Iron Binding Capacity (TIBC) ✅ Answer: D) Total Iron Binding Capacity (TIBC) Explanation: Pregnancy leads to increased TIBC due to higher transferrin synthesis to compensate for increased iron demand. Serum ferritin and iron decrease due to increased iron utilization. Hematocrit reduces due to physiological hemodilution , not an actual decrease in RBC mass. DR MARIA RAFI ;923324747587 2.  A 28-year-old female, para 2+0 , presents with Hb 7 g/dL . What is the next best investigation? A) Hb electrophoresis   B) Total iron-binding capacity (TIBC) C) MCV and peripheral smear ✅ D) Serum iron Answer: A) Hb electrophoresis Explanation: The first step is to check MCV (Mean Corpuscular Volume) to classify anemia...
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PULMONARY HYPERTENSION POINTS (FROM TOG Review Cardiac disease in pregnancy.Part 1:congenital heart disease)

 

Pulmonary Vascular Disease and Pregnancy: Key Facts

Overview

  • Pregnancy with pulmonary hypertension (PH) is high-risk due to strain on the heart and lungs.
  • Fixed pulmonary vascular resistance prevents increased blood flow needed during pregnancy.
  • Poor tolerance of pregnancy leads to severe complications and high maternal and fetal risks.

Maternal Risks

  • Pregnancy complications include:
    • Cyanosis: Low oxygen in the blood.
    • Hypoxia: Poor oxygen delivery to tissues.
    • Arrhythmias: Irregular heartbeats.
    • Heart failure: Reduced pumping ability of the heart.
    • Maternal mortality:
      • 36% in Eisenmenger syndrome.
      • 30% in primary pulmonary hypertension.
      • 56% in secondary pulmonary hypertension.
  • Highest risk of complications occurs:
    • At term or during labor.
    • Within the first postpartum week.

Fetal Risks

  • Limited oxygen and nutrients to the baby lead to:
    • Premature delivery in up to 50% of cases.
    • Restricted fetal growth.
    • Only 15–25% of pregnancies reach full term.

Antenatal Care (ANC)

  • Essential measures for high-risk pregnancies:
    • Specialist care involving cardiologists and obstetricians.
    • Close cardiovascular monitoring throughout pregnancy.
    • Bed rest from the third trimester.
    • Treatments to improve maternal and fetal outcomes:
      • Anticoagulation therapy to prevent blood clots.
      • Oxygen therapy to enhance oxygen levels.
      • Pulmonary vasodilators (e.g., nitric oxide, prostacyclin) to improve blood flow.

Intrapartum Care (During Delivery)

  • Critical considerations for delivery:
    • High-risk delivery requiring a tertiary care facility.
    • Specialized team: Cardiologists, anesthetists, obstetricians.
    • Preferred methods:
      • Vaginal delivery with close monitoring (in select cases).
      • Cesarean section to reduce physical stress on the mother.

Postpartum Care

  • High-risk period extends up to 14 days postpartum.
  • Care includes:
    • Monitoring for heart failure and other complications.
    • Continuing medications like anticoagulants and oxygen therapy.
    • Preventing postpartum complications through close observation.


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ANEMIA IN PREGNANCY : MCQS AND IMPORTANT MCQS By DR MARIA RAFI

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  1.  A 30-year-old pregnant female is undergoing routine blood tests . Pregnancy is associated with an increase in which of the following? A) Mean Cell Hemoglobin Concentration (MCHC) B) Serum ferritin concentration C) Hematocrit D) Total Iron Binding Capacity (TIBC) ✅ Answer: D) Total Iron Binding Capacity (TIBC) Explanation: Pregnancy leads to increased TIBC due to higher transferrin synthesis to compensate for increased iron demand. Serum ferritin and iron decrease due to increased iron utilization. Hematocrit reduces due to physiological hemodilution , not an actual decrease in RBC mass. DR MARIA RAFI ;923324747587 2.  A 28-year-old female, para 2+0 , presents with Hb 7 g/dL . What is the next best investigation? A) Hb electrophoresis   B) Total iron-binding capacity (TIBC) C) MCV and peripheral smear ✅ D) Serum iron Answer: A) Hb electrophoresis Explanation: The first step is to check MCV (Mean Corpuscular Volume) to classify anemia...
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