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IMF-054-02-0001-en	Why can a creatinine within the non-pregnant normal range indicate kidney impairment in pregnancy?	Renal plasma flow and filtration rise early in pregnancy and lower creatinine, so a value normal outside pregnancy may represent impairment.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0002-en	Why is the uterus displaced to the left during resuscitation in later pregnancy, and what is prepared early if cardiac arrest resuscitation is difficult?	Displacement reduces uterine compression of the aorta and vena cava; if resuscitation is difficult, emergency delivery of the uterine contents is prepared early according to gestation and fundal height.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0003-en	Why can respiratory failure and anaesthesia deteriorate rapidly in pregnancy?	Oxygen consumption rises and functional residual capacity falls as the diaphragm elevates, shrinking oxygen reserve during apnoea, while airway oedema and aspiration risk increase.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0004-en	What makes pregnancy hypercoagulable, and what is the trade-off?	Increased clotting factors, reduced fibrinolysis and venous stasis protect against delivery bleeding but raise venous thrombosis risk, especially postpartum and with surgery, immobility, obesity or thrombophilia.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0005-en	How does inadequate spiral-artery remodelling lead to pre-eclampsia, and why can placental flow be poor despite high maternal pressure?	Inadequate invasion and remodelling cause placental ischaemia and release antiangiogenic and inflammatory signals that injure maternal endothelium, so maternal pressure can be high while placental flow remains poor.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0006-en	Why is thiamine replaced before substantial carbohydrate in hyperemesis gravidarum?	Prolonged vomiting depletes thiamine, and giving substantial carbohydrate first can precipitate Wernicke encephalopathy.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0007-en	Why can pre-eclampsia be diagnosed without proteinuria?	It is a multisystem placental endothelial disease, so new hypertension after mid-pregnancy with kidney, liver, neurological, haematological, pulmonary or placental dysfunction meets the syndrome.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0008-en	Why is the newborn of a mother with gestational diabetes at risk of hypoglycaemia after birth?	Maternal glucose crossing the placenta drives fetal insulin; at birth the placental glucose supply stops abruptly while neonatal insulin remains high.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0009-en	Why is vasa praevia dangerous to the fetus when membranes rupture?	Fetal vessels cross the membranes near the cervix, so membrane rupture can produce catastrophic fetal bleeding.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0010-en	Why is fetal heart monitoring not read as a direct measure of fetal oxygenation?	It reflects the autonomic response to oxygenation, so baseline, variability, accelerations, decelerations, contractions, gestation, medicines and context are interpreted together.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0011-en	Why is traction on the fetal head avoided in shoulder dystocia, and what is used instead?	Traction does not release the shoulder and can injure the brachial plexus; maternal positioning, suprapubic pressure, internal rotation or posterior-arm delivery are used, and fundal pressure is avoided.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0012-en	Why can an apparently mild fall in fibrinogen indicate severe obstetric haemorrhage?	Fibrinogen falls early in obstetric haemorrhage, and because its reference range is higher in pregnancy, a value that looks mildly low may reflect severe disease.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0013-en	Why should the physiological tachycardia and raised white-cell count of pregnancy not be used to dismiss sepsis?	Fever may not be prominent, so tachycardia, tachypnoea, hypotension, altered consciousness, oliguria and fetal tachycardia are early signs, and change over time and organ function carry more weight.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending
IMF-054-02-0014-en	Why is breastfeeding not automatically stopped when a mother needs a medicine?	Most medicines can be continued; safety depends on milk transfer, infant age, absorption, half-life, toxicity, alternatives and maternal need, and a blanket stop risks an untreated mother or unwanted weaning.	Integrated Medical Foundations; chapter 54, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: c5de16d17fdd591d666dfbccdc7f2a5756880dd20649dc7d24a34042c510381a; editorial review pending	imf lang::en chapter::054 module::054-02 review::pending