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IMF-054-01-0001-en	Why can a minor deterioration in maternal condition be dangerous in pregnancy?	Mother and fetus share placental circulation, so even minor maternal deterioration may threaten placental perfusion.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0002-en	What does a positive human chorionic gonadotropin test establish, and what does it not establish?	It confirms trophoblastic activity but does not by itself locate the pregnancy or prove viability; early ultrasound identifies location and cardiac activity.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0003-en	How is a pregnancy of unknown location managed, and until when?	With serial clinical assessment, hormone trends and imaging until intrauterine pregnancy, ectopic pregnancy, or loss is established.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0004-en	Why should anticonvulsants or other essential treatment not be withdrawn abruptly when pregnancy is confirmed?	Abrupt withdrawal of critical treatment such as anticonvulsants, steroids or psychiatric therapy may carry more risk than the drug exposure itself, so medicines are reconciled rather than simply stopped.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0005-en	Why is a mild anaemia in pregnancy often physiological?	Plasma volume rises more than red-cell mass, producing a physiological dilutional anaemia.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0006-en	How do renal adaptations in pregnancy affect laboratory interpretation and prescribing?	Renal blood flow and filtration increase, which alters creatinine values and drug clearance.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0007-en	Why do normal pregnancy adaptations make haemorrhage, embolism, infection and cardiac disease more dangerous?	Raised cardiac output and heart rate, lower systemic resistance, slowed gut motility and a clotting shift toward thrombosis reduce the reserve available for these events.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0008-en	Why can bleeding and cramping in early pregnancy not be assumed to mean miscarriage?	These symptoms overlap viable and ectopic pregnancy, so perfusion, pain, peritonism, haemoglobin, blood group, hormone level and ultrasound are assessed.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0009-en	Why do an absent risk factor and a low hormone level not exclude a dangerous ectopic pregnancy?	Many patients with ectopic pregnancy have no risk factor, and rupture can occur even with low hormone levels.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0010-en	How does stability determine the management of ectopic pregnancy?	Unstable or ruptured ectopic pregnancy needs immediate surgery and resuscitation, whereas stable cases can receive methotrexate or observation with reliable follow-up.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0011-en	What distinguishes chronic hypertension, gestational hypertension and pre-eclampsia?	Chronic hypertension predates pregnancy or appears early; gestational hypertension develops later without defining organ injury; pre-eclampsia is new hypertension after mid-pregnancy with proteinuria or maternal organ dysfunction.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0012-en	What processes give rise to pre-eclampsia, and why can it affect many organs?	It arises from abnormal placentation, endothelial dysfunction, vasoconstriction, inflammation and capillary leak, so dysfunction can involve kidney, liver, brain, blood or placenta.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0013-en	Delivery is the definitive treatment of pre-eclampsia. Why is it not always performed immediately?	When mother and fetus are stable, delivery is balanced against prematurity, with corticosteroids given to accelerate fetal lung maturation when early birth is likely.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0014-en	Why does gestational diabetes develop in some pregnancies but not others?	Placental hormones raise insulin resistance to direct nutrients toward the fetus, and diabetes appears when beta-cell compensation is inadequate.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0015-en	Why do insulin requirements change after placental delivery, and why is glucose reassessed postpartum?	Requirements fall sharply once the placenta, the source of the resistance-raising hormones, is delivered; glucose is reassessed because future type two diabetes risk remains high.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0016-en	What typically distinguishes bleeding from placenta praevia, and what examination is withheld until placental location is known?	Placenta praevia overlies or approaches the cervical opening and commonly causes painless bleeding; digital vaginal examination is avoided until placental location is known.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0017-en	Why can visible blood loss underestimate the severity of placental abruption?	Haemorrhage from the premature placental separation can be concealed, so visible loss underestimates severity and resuscitation with blood-product readiness is essential.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0018-en	What does anti-D immunoglobulin prevent, and when is it given?	It prevents sensitisation, in which a susceptible pregnant person forms antibodies against fetal red cells; it is given antenatally, postpartum, and after potentially sensitising events.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0019-en	What correctable causes can a concerning fetal heart pattern point to during labour?	Maternal hypotension, excessive contractions, cord compression or hypoxia, which are corrected while deciding whether expedited birth is needed.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0020-en	Why does umbilical cord prolapse require pressure relief and emergency delivery?	The prolapsed cord compromises fetal blood flow, so pressure on it is relieved and birth is expedited as an emergency.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0021-en	What four mechanisms cause postpartum haemorrhage, and why must the cause be identified?	Uterine atony, retained tissue, genital trauma and coagulopathy; each needs its own treatment, namely uterotonics, removal of tissue, repair, or correction of coagulation.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0022-en	Why should a preserved blood pressure not reassure during postpartum haemorrhage?	Shock may develop before any dramatic fall in blood pressure, so a maintained pressure does not exclude shock.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0023-en	What roles do prolactin and oxytocin play in lactation, and what establishes milk supply?	Prolactin supports milk production and oxytocin causes milk ejection; early skin contact, effective attachment and frequent milk removal establish supply.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending
IMF-054-01-0024-en	What distinguishes postpartum blues from postpartum illness that needs urgent assessment?	Blues are brief and common, whereas persistent depression, anxiety, intrusive thoughts, mania, psychosis, suicidality or inability to care need urgent assessment; postpartum psychosis is an emergency.	Integrated Medical Foundations; chapter 54, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 1d9b47bf1c4754cb7f0c9d50a86e1246545bd656f7c88590bbefe947721019af; editorial review pending	imf lang::en chapter::054 module::054-01 review::pending