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MIDW 201 > CBL 6_GBS screening and prophylaxis_prepping for birth > Flashcards

CBL 6_GBS screening and prophylaxis_prepping for birth Flashcards

1
Q

How do you store GBS swab?

A

4 degrees Celsius
Processed within 24 hours of collection.

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2
Q

What does CBC look for?

A

Broadly: hemoglobin, mean corpuscular volume, and platelets and some other biz

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3
Q

When do we repeat anemia screening?

A

28 weeks

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4
Q

Why do we repeat anemia screening?

A

Hemodilution of the blood; screening for risk of tolerance to hemorrhage

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5
Q

Lab value hemoglobin first/third trimester?

A

<110 g/L

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6
Q

Lab value hemoglobin second trimester?

A

<105 g/L

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7
Q

Lab value ferratin diagnostic of iron deficiency in first trimester?

A

<15 µg/L

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8
Q

How common is anemia in pregnancy in Canada?

A

30 %

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8
Q

Lab value indicative of probable iron deficiency (begin mgmt. with oral supplementation)?

A

<30 µg/L

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9
Q

What are the risk of anemia in pregnancy? (7)

A

Preterm birth
Low birth weight
Placental abruption
Pre-eclampsia
PPH
Transfusion
Depression

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10
Q

How does WHO define anemia?

A

Hb < 110 in 1st trimester
Hb < 105 in 2nd trimester (due to hemodilution)
Postpartum HB < 100

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11
Q

What is the oral supplementation recommendation for anemia?

A

a standard therapeutic dose of 100 mg elemental iron per day

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12
Q

What is the calculating dose to administer IV iron?

A

Iron needs (mg iron) = body weight (kg) * (target Hb – actual Hb) * 2.4 + depot iron need (mg iron)

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13
Q

Labs recommended 0-14 weeks? 11

A

Blood group and antibody screen
CBC – hematology profile
Ferratin
TSH *risk factors but not really
HIV
Syphilis
Hep B
Hep C *risk factors
Rubella antibody titre *if first preg
Chlamydia/Gonorrhea
Urine C&S (UTI)

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14
Q

Labs recommended 24-28 weeks?

A

Repeat antibody screen in Rh negative clients
Gestational diabetes screen
CBC and ferritin at 28 weeks

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15
Q

Labs recommended 35-37 weeks?

A

Group B strep Screen

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16
Q

When RhoGam administered?

A

28 weeks

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17
Q

When use Edinburgh perinatal/postpartum depression scale?

A

In between 28-32 weeks prenatally
6-8 weeks pp

(anytime is valid)

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18
Q

Do we use EPDS universally?

A

Yes

19
Q

Scoring breakdown of EPDS?

A

Less than 8 – depression not likely
9-11 – depression possible
12-13 – fairly high possibility of depression
14 and higher - probable depression
Positive score on question 10 – suicidality risk

20
Q

What are the 4 principles of TIC approach?

A

Having trauma awareness
Establishing safety and trustworthiness
Ensuring choice, collaboration, connection
Building on strengths

21
Q

What is GBS?

A

Group B streptococcus – bacteria found in gut, vagina, anus
Not an STI, not a sign of cleanliness
Transient bacteria

22
Q

What is the incidence of GBS in pregnancy ?

A

1.5-4/10 – very common

23
Q

What is the incidence of GBS infection for baby?

A

2.3/10 000 (rare)0.2 %

24
Q

What is the incidence of a baby dying from EOGGBDS?

A

1.15/100 000 (very rare) 0.001 percent

25
Q

Community standard managing positive GBS swab?

A

IV admin of prophalytic antibiotics every 4 hours till birth of bb starting when membranes rupture or during active labour (whatever comes first)

26
Q

Who does SOGC recommend Abx to for GBS? (3)

A
  • any woman positive for group B streptococcus by vaginal/rectal swab culture screening done at 35 to 37 weeks’ gestation (II-2B);
  • any woman with an infant previously infected with group B streptococcus (II-3B);
  • any woman with documented group B streptococcus bacteriuria (regardless of level of colony-forming units) in the current pregnancy. (II-2A)
27
Q

Chances of EOGBDS following community standard?

A

3/1000

28
Q

Chances of death from EOGBSD following community standard?

A

3/10,000

29
Q

Chances of EOGBDS following risk factor approach?

A

5/1000

30
Q

Chances of death following risk factor approach?

A

5/10,000

31
Q

Chances of EOGBDS taking no abx?

A

10/1000

32
Q

Chance of death taking no abx?

A

10/10,000

33
Q

Risk factor approach to GBS positive? (4)

A

Taking abx:
ROM more than 18 hours
Preterm labour
Previous child with GBS disease
Fever above 38 degrees

34
Q

Signs of newborn with EOGBSD? (5)

A

Fever
Lethargic
Poor feeding
Central cyanosis
Stop breathing

35
Q

When are fetal movements typically felt?

A

Usually by 20-22 weeks

36
Q

How many fetal movements should a pregnant person feel at the end of pregnancy?

A

Six movements within 2 hours

37
Q

What’s maternal colonization rate of GBS (comp. mid)?

A

10-35 %

38
Q

Colonization rate of GBS among newborns who are colonized and not treated (comp mid)?

A

50 %

39
Q

Rate of early onset GBS disease among colonized newborns (comp mid)?

A

1-2 %

40
Q

Average risk of any baby in the population having early onset disease (comp mid)?

A

0.2 %

41
Q

How much does screening and abx reduce the rates of EOGBSD? (comp mid)?

A

65-85%

42
Q

How much does risk factor mgmt. of GBS reduce the rates of EOGBDS ((comp mid)?

A

51-75%

43
Q

When does EOGBSD happen?

A

1-7 days

44
Q

When does late onset GBS disease happen?

A

7-31 days

45
Q

When do we start measuring fundal height?

A

12 weeks

46
Q

What is the most accurate way to see if SFH is normal?

A

Plotting on curve

MIDW 201 (10 decks)

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