TEALE FENNING

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 966

foetal morbidity is more in untreated cases Vs patients on treatment of the following diseases.....

Diabetes

Epilepsy

SLE

Crohn's disease

Laughing

_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region

wolverine · Century Club Joined: 16 Jan 2007 Posts: 394

Well controled mat diabetes should have outcomes similar to uncomplicated pregnancies. (True)
Epilepsy is tricky. Antiepileptics increase fetal morbidity with various ways but untreated epilepsy (probably you mean fitting free??) still has a doubled risk for malformations and 6% of epilepsy of the offspring when mother is epileptic and 15% if both parents are. (Unsure T/F)
SLE? What is the treatment for SLE? Hydroxychloroquine, azathioprine are safe, NSAIDS cyclophosphamide methotrexate to be avoided. I think fetal morbidity though is high regardless.. (IUGR, stillbirth, abruption). (False)
Crohn's if untreated exacebration in pregnancy can increase foetal morbidity yes. (True)

Nick Raine-Fenning · Posted: Sat Jan 27, 2007 5:24 pm Post subject:

All true

This remains the case even if you add the famous Teale Fenning disease to the list! Laughing

The key concept and an important point for your essays is that the treatment and stabilisation of any medical disorder, even if this involves medication, is more likely to result in a good outcome than pregnancy in a patient with untreated illness.

Remember the rules though ...

change polypharmacy to monotherapy wherever possible (in consultation with an appropriate physician of course)

change to the least teratogenic drug(s) 3 months prior to pregnancy

continue an appropriate form of contraception until the disease is stabilised

Cool

_________________
"Teale Fenning Medical Education" delivering evidence-based, exam-orientated learning since 1997

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 966

all true except epilepsy......

background risk for malformations in epileptics is high, and will be further increased with adding drugs, even though it is mono Vs poly pharmacy,

most anti epileptics are associated with some malformation or the other except lamotrigine -- so says data available till date.

if you take an epileptic, not on medication and seizure free for say 5 / 10 yrs her risk for malformation will be lesser than one on any sort of current drug therapy.

that is how i understand it. any other thoughts.
_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 966

foetal morbidity is more in untreated cases Vs patients on treatment in Teale Fenning disease --------

100% true.
Wink

_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region

wolverine · Century Club Joined: 16 Jan 2007 Posts: 394

There is no treatment currently for teale-fenning disease.
I have the same understanding for epilepsy

wolverine · Century Club Joined: 16 Jan 2007 Posts: 394

The teale-fenning disease is characteristically associated with mopsyism-related stress. TTTTRRRRRUUUUUEEEE

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 966

Nick Raine-Fenning · Posted: Sun Jan 28, 2007 6:41 am Post subject:

That's expensive treatment reserved for the rich with personal insurance Wink

I understand what you are saying about epilepsy but I think you are too clever for the question. I think the person who set this is actually imaging an unstable epileptic and comparing them to one on drugs. In fact the overall risk of anomalies with any drug (including all the anti-epileptics and even lithium) is not very high and the vast majority of women have normal babies and normal outcomes. Untreated women get complications, totally unrelated to drug therapy, such as fitting, IUGR, stillbirth etc that make the outcome worse for mother and baby.
_________________
"Teale Fenning Medical Education" delivering evidence-based, exam-orientated learning since 1997

Abik · Posted: Sun Jan 28, 2007 3:41 pm Post subject:

I agree with Nick (it's safest!)
Seriously though, I think the answers for the MCQ's are simpler than we make them. Go with your guts - it has to be overall sfaer for the foetus to have a well-controlled epileptic mother.
Abs

Nick Raine-Fenning · Posted: Mon Jan 29, 2007 11:31 am Post subject: