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ANC Flashcards

1
Q

How many conceptions per year int he UK?

A

850,000

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2
Q

Which is the only age group not to decreased in conception rates?

A

> 40 y/o

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3
Q

How many abortions in the UK per year?

A

200,000

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4
Q

Which vitamin should you not take too much of?

A

Vit A

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5
Q

How many mg of folic acid should you take. When should you start and stop taking it?

A

400ug
Every day before your pregnant
Until you’re 12 weeks pregnant

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6
Q

6 reasons to take a higher dose folic acid

A 
You/your babys father has NTD
You/your babys father have FHx NTD
You have DM 
You've had previous pregnancy affected by NTD
You take anti-epilepsy meds 
You take ARV Dx for HIV
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7
Q

Which other vits/mins should you take/include in your diet pre-conceptually?

A

Vit D
Iron
Vit C
Calcium

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8
Q

What is the Healthy start scheme?

A

Provides vouchers to pregnant women + families

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9
Q

When does the Booking Screen take place?

A

Before 10 weeks

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10
Q

Who does the Booking Screen?

A

The midwife

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11
Q

What is the aim of the Booking Screen?

A

To ID any RF that might indicate need for > surveillance

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12
Q

Components of examination in The Booking Screen

A

W + h –> BMI
BP
Urinalysis
Palpating uterine size abdominally

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13
Q

Investigations undertaken in the Booking Screen (7)

A 
FBC
Haemoglobin electrophoresis 
Blood group + ab screen 
Antibody screen 
Screening for BBV
CO
USS
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14
Q

Which component of FBC is normally raised in pregnancy?

A

Neutrophils

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15
Q

What 2 components of FBC are we most interested in @ Booking screen?

A

Anaemia/Hb

Platelets

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16
Q

What could a rising antibody titrate at booking indicate?

A

Fetal anaemia

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17
Q

What 4 BBV are routinely screened for @ Booking?

A

Rubella
Syphilis
Hep B
HIV

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18
Q

What can high CO levels –>

A

Small baby

Cot death

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19
Q

What is the USS at booking looking at?

A

Fetal viability
Gestational age
ID/exclude multip
Nuchal translucency

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20
Q

How to estimate due date?

A

Add 9 months + 7 days to 1st day of LMP

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21
Q

Advise on exercise in pregnancy?

A

Safe to continue but easier to strain a mm because of increased progesterone levels

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22
Q

How to wear seatbelts in pregnancy?

A

Above/below month

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23
Q 
Why avoid these foods in pregnancy?
Soft cheese
Unpasteurized milk + cheese 
Uncooked fish 
Chill-cook meals
A

Listeria –> miscarriage or stillbirth

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24
Q

Why avoid these foods in pregnancy?
Unwashed fruit/veg/salad
Raw/rare meat
Unpasteurized milk

A

Toxoplasma –> miscarriage, still birth or LT disability

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25
Why avoid these foods in pregnancy? Shellfish Uncooked egg
Salmonella/food poisoning --> ppt premature labour
26
Define antepartum haemorrhage
Bleeding from genital tract after 24 weeks gestation
27
Common causes APH (3)
Undetermined origin Placental abruption Placenta praevia
28
Rarer causes APH (3)
Incidental genital tract pathology Uterine rupture Vasa praevia
29
Prevalence placenta praevia
0.4%
30
Define placenta praevia
Where the placenta is fully/partially implanted in the lower uterine segment
31
What are the 2 main types of placenta praevia?
Minor placenta praevia | Major placenta praevia
32
What is minor placenta praevia?
Placenta is low, doesn't cover internal os
33
What is major placenta praevia?
Placenta lies over internal os
34
Risk factors for placenta praevia (7)
``` Previous C section High parity Maternal age >40 Multiple pregnancy Prev placenta praevia Hx uterine infection Curettage to endometrium after miscarriage/termination ```
35
Clinical features placenta praevia
intermittent painless vaginal bleeding | Uterus usually not tender on palpation
36
Baby on examination in placenta praevia?
Baby often in breech + transverse lie | Foetal head high + not engaged
37
What must you NOT do in placenta praevia
Perform a VE
38
What is placenta accreta
If placenta implants in previous C section scar
39
What is placenta percreta
If placenta penetrates uterine wall into surrounding structures e.g. bladder
40
What investigations would you do for placenta praevia? | Which is for definite diagnosis?
USS ** definite diagnosis CTG FBC, clotting, cross-match, G+S
41
Management P.praevia
``` A-E Scan @20W If minor - repeat @ 36W If major - repeat @32W If bleeding - Admit Steroids if <34weeks C-section @ 39W ```
42
Prevalence placental abruption
1%
43
What is placental abruption?
Where part/all placenta separates from wall of uterus prematurely
44
What are the 2 main types of placental abruption?
Revealed | Concealed
45
What is revealed placental abruption
Bleeding --> drains through cervix --> vaginal bleed within uterus --> clot retroplacentally
46
What is concealed placental abruption?
Bleeding remains within uterus --> clot retroplacentally. Can still --> systemic shock
47
RF: Age <18 (2)
Hypertensive disorders | IUGR
48
RF: Age >38 (4)
Fetal chromosomal abnormality IUGR Stillbirth after 40 weeks Hypertensive disorders
49
RF: Weight @ booking - <45kg
IUGR
50
RF: Weight @ booking - >100kg (4)
Hypertensive disorders Impaired glucose tolerance Shoulder dystocia Thromboembolism
51
RF: Primaparous
Pre-eclampsia
52
RF: Grandmultiparous (>4) (5)
``` Anaemia IUGR Malpresentation Unstable lie PPH ```
53
RF: Previous removal placenta (3)
Recurrence retained placenta P. praevia PPH
54
RF: Previous C-section
Placenta praevia
55
RF: Prev baby >4kg
Shoulder dystocia
56
RF: Hypertension
Hypertensive disorders
57
RF: Insulin dependent DM (6)
``` Miscarriage Stillbirth Congenital anomaly Macrosomia Shoulder dystocia Neonatal hypoglycaemia ```
58
RF: Epilepsy (5)
``` Cardiac abnormalities Palate abnormalities NTD Haemorrhage disease of newborn Labile drug levels ```
59
RF: Thyroid disease (2)
Maternal thyroid storm | Neonatal hypo/hyperthyroidism
60
RF: Recurrent UTIs (2)
Premature labour | IUGR
61
RF: Psychiatric disorders
Acute exacerbation in post natal period
62
RF: Anorexia nervosa
IUGR
63
RF: Cone biopsy
Cervical incomptency and midtrimester miscarriage
64
RF: Genital herpes
Neonatal herpes encephalitis
65
RF: Diabetes
Impaired glucose tolerance Macrosomia Organomegaly
66
RF: Domestic violence (4)
Physical injury Depression + suicide Premature labour IUGR
67
RF: Cigarettes + cannabis (4)
IUGR Neonatal respiratory distress Cot death Childhood asthma + ear infections
68
RF: Alcohol - >4 units /day
Foetal alcohol syndrome - cardiac defects
69
RF: Alcohol >8 units/day
Foetal alcohol syndrome - abruption
70
RF: Cocaine (4)
IUGR Premature labour Microcephaly Cot death
71
RF: Amphetamines (3)
Palate abnormalities Cardiac abnormalities IUGR
72
RF: MDMA
MSK + cardiac abnormalities
73
RF: Barbituarates
Neonatal withdrawal
74
RF: Smoked heroin (4)
Miscarraige Stillbirth IUGR Neonatal withdrawal
75
RF: Injected heroin (3)
Hep B Hep C HIV
76
RF: Methadone
Neonatal withdrawal
77
RF: Assisted conception (3)
Multiple pregnancy Premature labour IUGR
78
RF: Recurrent antepartum haemorrhage
IUGR
79
RF: Multiple pregnancy (7)
``` Miscarriage Chromosomal abnormality Hyperemesis Premature labour Anaemia IUGR PPH ```
80
RF: Fibroids (2)
PPH | Unstable lie/obstructed labour if in lower segment uterus
81
For what reasons would an early pregnancy scan be carried out? (3)
If there has been: Pain Bleeding Hyperemesis gravidarum
82
What is the most accurate way to date a pregnancy on USS?
C-R length between 6-12w
83
What is the most reliable way after 14 weeks to date a pregnancy?
Biparietal diameter
84
What measurements on USS are used to estimate fetal weight?
Head circumference | Abdo circumference
85
When is nuchal translucency carried out?
11-13 w + 6
86
What may Incr NT reflect?
Heart failure | Chromosomal abnormalities
87
When is the anomaly scan undertaken?
18-22w
88
What does the anomaly scan involve looking at?
``` Skull shape Internal structures Abdo, spine, arms legs Heart Face and lip ```
89
What does the doppler USS measure?
Blood flow in uterus, placenta and fetus

CP2 OBGYN (21 decks)

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