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Midwifery > Antenatal > Flashcards

Antenatal Flashcards

Anaemia, bloods, weight gain, nutrition, screening (61 cards)

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1
Q

What is the recommended iodine supplementation dose for pregnancy?

A

150mcg PO a day

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2
Q

When should a woman take iodine supplementation?

A

When pregnant and breastfeeding

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3
Q

Why should a woman take iodine supplementation during pregnancy?

A

To help the fetal body grow and development, especially the brain

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4
Q

What are the consequences of low iron in pregnancy?

A

Can lead to hypothyroidism that can cause congenital anomalies and decreased fetal intelligence

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5
Q

What is the recommended folic acid supplementation in pregnancy?

A

800mcg PO a day

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6
Q

When should a woman take folic acid supplementation?

A

Four weeks before pregnancy through to 12 weeks gestation

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7
Q

Why is folic acid supplementation recommended in pregnancy?

A

To help prevent neural tube defects like spina bifida

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8
Q

What are the consequences of low folic acid in pregnancy?

A

Increases the risk of neural tube defect e.g. spina bifida

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9
Q

What is the recommended iron supplement dose in pregnancy?

A

27 mcg / 200mg PO once or twice a day depending on ferritin levels

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10
Q

The purpose of ordering Ferritin level in early pregnancy is to establish the baseline indication of:

A

Iron stores

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11
Q

Why is iron supplementation recommended in pregnancy?

A

For growth and development as the baby uses the maternal iron to make haemoglobin

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12
Q

What are the consequences of low iron in pregnancy?

A

Anaemia. Increased risk of low birth weight and premature delivery. Increased maternal tiredness, reduced milk production and depression

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13
Q

Within the midiwifery scope of practice, what does preconception advice cover?

A

Suggesting taking folic acid and maternal screening. Also may include referring to obstetrician for genetic counselling

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14
Q

When are bloods taken in pregnancy?

A

Booking visit (before 12 weeks)
26 - 28 weeks
36 weeks

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15
Q

What is tested for in the booking bloods?

A
  • Ferritin
  • FBC
  • Antibody screen (Rh factor, white and red blood tells, hb level)
  • STI’s (HIV, syphilis)
  • Rubella antibodies
  • HbA1c diabetes
  • Blood group
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16
Q

What is tested for in the 26 - 28 week bloods?

A
  • Ferritin
  • Antibody screen
  • FBC
  • Polycose
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17
Q

What is tested for in the 36 week bloods?

A
  • Ferritin

- Antibody screen

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18
Q

What is the healthy weight gainer singleton pregnancy with BMI <18.5

A

12.5 - 18kg

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19
Q

What is the healthy weight gainer singleton pregnancy with BMI 18.5 - 24. 9?

A

11.5 - 16kg

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20
Q

What is the healthy weight gainer singleton pregnancy with BMI 25.0 - 29.9

A

7kg - 11.5kg

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21
Q

What is the healthy weight gainer singleton pregnancy with BMI >30

A

5 - 9 kg

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22
Q

What are risk factors for the mama with increased BMI?

A
  • Gestational diabetes
  • Failed IOL
  • C-section
  • Delayed lactogenesis
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23
Q

What are risk factors for the baby with a mama with an increased BMI?

A
  • LGA

- Birth injury

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24
Q

What are the three types of diabetes testing?

A
  • HB1AC at booking (average BSL over last 6 - 8 weeks)
  • GCT - Glucose Challenge Test (1 hour)
  • GTT - Glucose Tolerance Test (diagnostic - 2 hour test - fasting)
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25
Low BMI and GWG risks
- Miscarriage - SGA - Premature birth
26
How is iron deficiency anaemia diagnosed?
Hb <100g/l and Fe <15umol/L
27
What is the haemoglobin normal range?
100 - 145g/L
28
What is the normal serum ferritin normal range?
30 - 170 umol/L
29
What treatment would you give for hb>100 and fe >30
No treatment
30
What treatment would you give for hb <100 and fe >30
Diagnosis with anaemia, could commence low dose iron therapy
31
What treatment would you give for hb <100 and fe <30
Discuss dietary options and consider low dose iron supplementation
32
What treatment would you give hb >100 and <15
Low dose iron supplementation = 1x ferrotab (ferrous fumarate 200mg tab) and retest in 4 weeks = if haven't improved = high dose iron supplementation
33
What treatment would you give for hb <100 and fe <15
Diagnosis with iron deficiency anaemia. Start high dose iron supplementation = 2x ferrotab or 1 ferrogradument (325mg controlled release). Give advice on how to avoid constipation. Refer for IV iron therapy if hb <70g/L or can't take tablets
34
What sources of food can you get folic acid from?
Leafy green vegetables (spinach, silver beet, broccoli, cabbage, whole grains)
35
What sources of food can you get iodine from?
Fish Seafood Seaweed
36
What sources of food can you get iron from?
Red meat Fish/Seafood Eggs Wholegrain or fortified breads Green leafy vegetables (spinach) Dried fruits Nuts Seeds Marmite/Vegemite
37
What sources can you get vitamin d from?
90% from sunlight coffee, liver, oily fish (salmon) Fortified dairy products (butter, milk ,eggs)
38
What food can you get calcium from?
Milk Cheese Butter Yoghurt Dried apricots Tinned fish with bones (salon, sardines)
39
What is vitamin D important for in pregnancy?
For general fetal growth and development Muscle function, formation of the fetal skeleton Bone health and aids in calcium absorption
40
What is calcium important for in pregnancy
For healthy bones and teeth Is often used to regulate blood pressure and can be preventative in hypertension disorders (used in combination with LDA)
41
What are risk factors for having low folic acid?
- Relevant family history - Obese - Diabetic - Anticonvulsant therapy
42
What is the recommended dose of folic acid for those at high risk of being deficient?
5mg PO daily
43
What aids iron absorption?
Vitamin C
44
Once commencing iron supplementation how long should you wait to recheck levels?
4 weeks
45
Who is at high risk of being vitamin D deficient?
Dark skin Covered skin Higher BMI
46
What is the recommended dose of vitamin D?
10 - 15mcg PO daily Should also be taking calcium
47
Who is at risk of needing calcium supplementation?
Preeclampsia Hypertension Preterm birth Low birth weight
48
What is the recommended dose of calcium?
1g daily (2x 500mg calcitab)
49
When should pregnant mama be taking calcium?
Use between 12 -16 weeks up until 36 weeks gestation
50
What is required for mss1 screening?
Blood test and nuchal translucency scan in the first trimester
51
What is the recommended timeframe for MSS1 screening - blood test and scan
Blood test: 9 - 13 + 6 weeks NT scan: 11 - 13 + 6
52
What is required for MSS2 screening?
NT scan
53
When can MSS2 screening be completed?
Between 14 and 20 weeks
54
When can NIPT be completed?
A blood test after 10 weeks gestation
55
When should aspirin be commenced if needed?
Between 12 - 16 weeks and stopped at 36 weeks
56
What category referral is required for hb <90 and not responding to treatment?
Consultation
57
What is haematocrit (HCT)
Percentage of RBCS relative to the portion of plasma
58
What is mean cell volume?
Size of RBC's
59
What is mean cell haemoglobin?
Average amount of hb in RBCs
60
Who should have high dose folic acid supplementation?
- Previous history of NTD - Family history of NTD - High BMI >30 - Coelic disease - Anticonvulsants
61
Morag's haemoglobin is 70g/L and Ferriting 6ug/L at 36 weeks of gestation. Your plan would be to:
Refer Morag for a consultation so she can be prescribed IV Iron therapy (Ferinject).

Midwifery (36 decks)

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