1.09

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Study Notes

Fetal Pharmacotherapy

Medications are administered to the mother and cross the placenta to treat the fetus.
Used for serious fetal conditions such as:
- Arrhythmias
- Congenital Adrenal Hyperplasia
- Congenital Cystic Adenomatoid Malformation
- Thyroid Disease
Diagnosis of fetal disorders involves intrauterine techniques including:
- Sonology
- Amniocentesis
- Cord blood sampling

Fetal Arrhythmias

Diagnosed through fetal M-mode sonography and Fetal 2D-echo.
Premature Atrial Contractions are the most common arrhythmia, occurring in 1-2% of pregnancies.
These contractions indicate immature cardiac conduction but typically resolve by late gestation or shortly after birth.
Tachyarrhythmia is characterized by a fetal heart rate (FHR) greater than 180 beats per minute (bpm).
Bradyarrhythmia is recognized by a significantly reduced fetal heart rate, which can indicate various complications.

Congenital Adrenal Hyperplasia (CAH)

Autosomal recessive genetic disorder resulting from enzyme deficiencies.
Impairs cortisol synthesis in the adrenal cortex from cholesterol during fetal development.
Over 90% of CAH cases are due to 21-hydroxylase deficiency.
Excess production of androstenedione and testosterone leads to virilization of female fetuses.
Maternal treatment with dexamethasone used to suppress excessive fetal androgen production.

Congenital Cystic Adenomatoid Malformation (CCAM)

Characterized by well-circumscribed lung masses, which can be solid or cystic formations.
Cysts that measure ≥5 mm are classified as macrocystic.
Also known as congenital pulmonary airway malformation (CPAM).
Treatment often involves corticosteroids to manage symptoms and growth.

Thyroid Disease in Pregnancy

Thyroid diseases during pregnancy are rare and often identified through sonographic detection of fetal goiter.
Immediate determination of fetal hyperthyroidism or hypothyroidism is crucial for effective management.
Treatment goals include correcting physiological irregularities and reducing the size of the goiter.

Fetal Thyrotoxicosis

Fetal thyrotoxicosis leads to maternal antithyroid treatment to manage excessive thyroid hormone levels.

Fetal Hypothyroidism

Fetal hypothyroidism is treated with maternal administration of levothyroxine to ensure proper hormone levels for fetal development.

Surgical Therapy

Maternal-fetal surgery addresses congenital abnormalities likely to cause fetal deterioration.
Open fetal surgery is a specialized procedure requiring comprehensive preoperative counseling and teamwork among various medical disciplines.

Description

Explore the intricacies of fetal pharmacotherapy, focusing on medications administered to mothers that impact fetal health. This quiz delves into the treatment of serious fetal conditions such as arrhythmias and congenital disorders, along with diagnostic methods like sonology and amniocentesis.