Hematologic Complications of Pregnancy

Hematologic Complications of Pregnancy

By:Joseph Breuner, MD

outline

* Anemia

* Thrombophilias

* Thrombocytopenia

Case #1

* Anemia, pro’s and cons of treating

Which patients will benefit from iron treatment?

What hematocrit at 28 wks should generate attention?

* Dilutional or physiologic

* Iron Deficiency Anemia

* Thalassemias

Physiologic Anemia of Pregnancy

* Pregnancy-induced hypervolemia has several important functions:

1. To meet the demands of the enlarged uterus with its greatly hypertrophied vascular system.

2. To protect the mother, and in turn the fetus, against the deleterious effects of impaired venous return in the supine and erect positions.

3. To safeguard the mother against the adverse effects of blood loss associated with parturition.

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Psychiatric Complications of Pregnancy and the Postpartum

Psychiatric Complications of Pregnancy and the Postpartum
By:Joseph Breuner, MD
Swedish Family Medicine Residency

Objectives
    * Appreciate the postpartum period as a time of increased vulnerability to psychiatric illness
    * Recognize and diagnose psychiatric illness during pregnancy and the postpartum
    * Understand risks to the fetus of psychiatric medications
    * Prevent and treat psychiatric illness in pregnancy and the postpartum

Outline 1
    * Review DSM-IV diagnoses
    * Psychiatric illness during pregnancy
    * Psychiatric illness in the postpartum

But first, a review
DSM-IV Definition of...

    *   For at least one week (or less, if hospitalized) the patient's mood is
    *   abnormally and persistently high, irritable or expansive.
    *   To a material degree during this time, the patient has persistently had 3 or
    *   more of these symptoms (4 if the only abnormality of mood is irritability):
    *   -Grandiosity or exaggerated self-esteem
    *   -Reduced need for sleep

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Finger pulse oximeter

A finger pulse oximeter measures a person’s blood oxygen saturation and pulse rate. They are widely used in the medical field and are also commonly used by pilots, athletes as well as people that work or train at high altitudes. A person’s entire body can be deprived of an adequate supply of oxygen, which is known as generalized hypoxia or simply a certain region of their body, commonly know as tissue hypoxia. This is a pathological condition that must be taken seriously and monitored. It is now easy and affordable to check your own heart rate and blood-oxygen saturation levels with a finger pulse oximeter.

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