Antenatal Care and Screening Flashcards
(38 cards)
In what conditions is morning sickness worse for pregnant women?
Conditions where Human Chorionic Gonadotropin is higher e.g twin, molar pregnancy.
What is a molar pregnancy?
Abnormal pregnancy in which a non-viable fertilised egg implants in the uterus and will fail to come to term.
What is Hyperemesis gravidarum?
Excessive nausea and vomiting during early pregnancy.
What are the symptoms of hypermedia gravidarum?
Prolonged and severe nausea and vomitng - can be up to 50x a day.
Dehydration
Ketosis
Weight loss
Hypotension when standing
When does morning sickness normally stop?
16 weeks
How does pregnancy affect the urinary system?
Increased urine output - renal plasma flow increases by 25-50%.
GFR increases by 50% and serum urea and creatinine decrease.
Increase in urinary stasis so UTI is more common. Hydronephrosis is physiological in 3rd trimester and makes pyelonephritis more common.
UTIs can be associated with preterm labour so important to treat.
How does pregnancy affect haematology?
Plasma volume increases by 50% RBC mass increases by 25% Hb drops by dilution. WBC increase slightly to 9000-12000/uL Platelet count falls by dilution.
When should iron supplements be given to a pregnant women?
Iron supplements should be given if HB is <110 or less than 100 on routine testing at 28weeks.
Adjust starting Hb with diet, liquid iron and tablets.
How does Progesterone affect CO2?
Progesterone acts centrally to reduce CO2.
This means tidal volume, respiratory rate, plasma pH and O2 consumption all increase.
How does pregnancy affect the GI tract?
Oesophageal peristalsis is reduced.
Gastric emptying slows
Lower oesophageal sphincter relaxes - reflux, heartburn.
GI motility reduced due to increase in progesterone and decrease in motilin.
What are some examples of pre-pregnancy counselling?
Improving diet
Optimise BMI
Reduce alcohol consumption
Smoking cessation advice
Folic acid- 400mcg to reduce risk of spina bifida.
Occupation - does job but them/baby at risk.
Substance misuse
What is Phenylketonuria?
Inborn error of protein metabolism which causes an inability to metabolise essential amino acid phenylalanine.
Results in mental development impairment.
What extra measures need to be taken if an expecting mother has Graves disease (hyperthyroid)?
Need treatment to keep their thyroid hormone levels normal.
Neonate will also need to be checked as thyroid stimulating antibodies can cross the placenta to the foetus.
What happens to type 2 diabetic women who are pregnant?
They need to be switched from oral hyopglycaemic medications to insulin.
They are more at risk of stillbirth, pre-eclampsia and marcosomic infants.
What are some maternal complications that need to be counselled to pregnant women who have previously given birth?
Risk of recurrence of:
Caesarean section
DVT
Pre-eclampsia
What are the actions required for previous pregnancy mothers to reduce their risk of recurrence?
Thromboprophylaxis
Low dose aspirin
What are some fetal conditions that have a risk of recurrence in women who have already had a pregnancy?
Pre-term delivery
Intrauterine growth restriction
Fetal abnormality
What are the actions required to prevent the recurrence of the fatal conditions that may affect woman who have had previous pregnancies?
Treatment of infection
High dose folic acid
Low dose aspirin
What are some examples of problems that could be picked up upon antenatal examination?
Mother - pre-existing or developing illness, anaemia, evolving hypertension, diabetes, pre-eclampsia.
Foetus - Small for gestational age, Foetal abnormality
Social - support, domestic violence, psychiatric illness.
What is checked upon abdominal palpation of a pregnant woman?
Assess symphyseal fundal height (SFH) Estimate size of baby Estimate liquor volume Lie of the baby Presentation
What can be offered if a baby remains in breech presentation after 36weeks?
ECV - external cephalic version.
Process of turning a breech baby into a cephalic baby so a vaginal delivery can occur.
What are some infections that are screened for in expectant mothers?
Hepatitis B - can provide passive and active immunisation for baby.
Syphilis - easily treated with penicillin.
HIV - maternal treatment and careful planning reduces vertical transmission
MSSU - UTI
Rubella antibodies indicating immunity due to prior infection or immunisation.
What can congenital rubella syndrome result in in the foetus and when does it occur?
Mental handicap
Blindness
Deafness
Heart defects
16 weeks
What does congenital syphilis result in the foetus?
Intrauterine growth restriction Hepato-splenomegaly Anaemia Thrombocytopenia Skin rashes
