Antenatal Care Flashcards

Question

Risks for placenta previa

Answer 1

Can't have VEs, PR and sex * Previous placenta previa * Previous c-section * Previous TOP * Multip * \>40 yrs * Multiple pregnancy * Smoking

Answer 2

Causes * Growing uterus puts pressure on bladder = stagnant urine Risks for * Sex * Anatomy anomaly * Catheter * Pregnancy Risks of * Recurrent UTI * Acute pyelonephritis * Kidney damage * Sepsis * Prematurity * SFD baby * Mental retardation * Developmental delay * Miscarriage Management * Fluids * Antiobiotics: penicillins and cephalosporins e.g. Cephalexin, Ampicillin

Answer 3

Risks for (see pictures) * Previous VTE * Thrombophilia * Several co-morbidities Risks of * Embolism (PE, stroke, MI) Management * Score \>4 consider thromboprophylaxis from first trimester. If 3 consider from 28 weeks. If 2 or under consider for 10 days. Consider if admitted to hospital. * Diagnosed with history and ultrasound * Treated urgently with Low Molcular Weight Heparins e.g. enoxaparin until proven to not be DVT

Answer 4

Risks for * Primip * South asain ethnicity * Prolonged second stage labour * Assisted delivery * LFD baby * Previous tear Risks of * Infection * Incontinence Management * Pain relief * Repair * Give antibiotics * Laxatives

Answer 5

First stage * Cervix going from 0-10 * Last 6-36 hours * Established labour: contractions are 5 mins apart and last at least a minute Second stage * Baby going down birth canal and being born * Lasts 30 mins-hour (epidural slows it) * This is the pushing part Third stage * Placenta delivery, two methods * Physiological management: wait for it to come out naturally, can take up to an hour, breast feeding helps * Active management: given syntoncinon in leg as shoulders are delivered, to help placenta seperate and decrease blood flow

Answer 6

Syntocinon * artificial oxytocin * Can be given IV for induction of labour, PPH prevention or established and incomplete, inevitable or missed miscarriage * Intramuscular for active management of third stage of labour (unliscenced) Ergometrine * Ergot alkaloid works non-specifically as 5-HT agonist and vasoconstrictor * Used to prevent PPH (generally with syntroncinon i.e. oxytocin as syntometrin) and for active management of third stage of labour * Can't be used in women with hypertension/pre-eclampsia Syntometrine * Combo of syntocinon and ergometrine * Prevention of PPH, active management of third stage of labour and bleeding due to incomplete abortion/miscarriage * Can't be used in hypertension/pre-eclampsia

Answer 7

Risks for * Mulitple pregnancy * Excessesive vomiting * Young or old maternal age * Anaemia before pregnancy * Bad diet Risks of * Preterm * SFD baby * Blood transfusion * Post partum depression * Folate deficiency = neural tube defects * Increased susceptibility to infection * PPH Managment * All women screened at booking and 28 weeks * Dietry advice should be given to all * If \<110 Trail iron for diagnostic and therapeutic reasons check in three weeks if unsuccessfull check serum ferritin and refer to consultant obstetrician * If \<90 higher dose of iron and refer to obstetrician if symptomatic * If \<70 refer urgently to obstetrician, offer transfusion if actively bleeding/symptomatic * If uncontrolled at delivery decrease risk of bleeding: CLC, IV access, group and save, active third stage labour, prompt management of PPH, prophylactic syntoncinon infusion

Answer 8

Aetiology * Body is not able to produce suffiecient insulin to keep up with pregnancy demands Risks for developing * BMI \>30 * Previous \>4.5 kilo baby * Previous gestational diabetes * FH diabetes Risks of * LFD baby therefore increased risk of induction, instrumental and c-section * Polyhydramnios * Premature birth * Pre-eclampsie * Neonate jaundice and hypoglycaemia * Still birth Management * Screened at 18-12 weeks * If at risk/random glucose in urine will be ofered oral glucose tolerance test * Fasting \>5.6 or 2 hour \>7.8 * Review in antenatal/diabetic clinic within a week * Educate: implication of diagnosis, importance of control, how to self-test, diet and excersice. * Use same glucose targets as for non-pregnant diabetics * Refer to dietitian * If diet and excerise doesn't make targets in 1-2 weeks offer metformin * If metformin contra-indicated/unacceptable offer insulin * Use a mix of diet, exercise, metformin and insulin to women who are difficult to control * If metformin doesn't work and woman can't/won't take insulin offer glibenclamide * CARE IS VERY DIFFERENT IF YOU ALREADY HAVE DIABETES SEE https://www.nice.org.uk/guidance/ng3/chapter/1-Recommendations#gestational-diabetes-2

Answer 9

Risks of high BMI in pregnancy * Gestational diabetes * Pre-eclampsia * Sleep apneoa * Miscarriage * Neural tube defects * Macrosomia * Stillbirth * Preterm birth * Anaesthetic complications * VTE * Slow labour progression * Shoulder distocia * PPH Management * Asses VTE, pre-eclampsia, gestational diabetes risk * Counsell risks high BMI posses * Counsell how to decrease said risks * CLC during labour

Answer 10

1. Cephalopeliv disproportion 2. Brown presentation 3. Cord/limb prolapse 4. Untreated HIV 5. Severe space occupying lesion 6. High birth weight 7. Placenta previa 8. Persistent fetal distress 9. High number c-sections 10. Maternal distress 11. Active herpes 12. Failure to progress 13. Acreta

Antenatal Care Flashcards

(34 cards)