Diseases of Human Systems - pregnancy & perinatal health

Question 1

what factors affect fertility?

Answer 1

age
smoking & alcohol
BMI
folic acid

Question 2

Describe the physical changes that occur in pregnancy

Answer 2

Increased weigtht from increase in tissue size, fluid and blood volume.

lower oesophageal sphincter relaxes = GORD

Type 2 diabetes (those who were prone/high risk to developing)

Compression of the bowel and bladder

Question 3

Describe the hormonal changes that occur in pregnancy

Answer 3

Increased oestrogen
Increased progesterone

These act on the kidney to increase plasma volume by 45%
(increase salt and water retention)

Question 4

Describe the haematological changes that occur in pregnancy

Answer 4

Increased blood volume - compensates from loss at birth and prevents hypovolaemia.

No increase in Hb its just diluted from the increased volume of blood = artificial anaemia

Question 5

Describe the cardiovascular changes that occur in pregnancy

Answer 5

Increased HR by 25% - from the relaxation of vascular smooth muscle

Vascular compression of the vena cava and aorta beneath the uterus when lying supine

Question 6

Describe the coagulation changes that occur in pregnancy

Answer 6

Increased turnover of clotting factors and fibrinolysis to allow the haemorrhagic changed during birth to be addresses rapidly = this increases the risk of DVT.

Question 7

What foods should pregnant mothers avoid and why?

Answer 7

raw meat and fish - toxoplasmosis

non-pasteurised milk and cheese - listeria

raw eggs - salmonella

malin, tuna, shark = high mercury content

spicy foods/fried foods - worsens GORD

internal organs of slaughtered animals e.g. haggis

Question 8

What is the placenta?

Answer 8

An interlinking mesh of blood vessels that allows the foetal circulation and maternal circulation to sit closely together and allow nutrients to diffuse but does not mix

Question 9

What is the danger of the placenta?

Answer 9

Some toxins and infections can diffuse via the placental barrier (some can’t as the molecules are too big i.e. HIV )

Question 10

If a mother has HIV how can we prevent the infection being passed to the child at birth?

Answer 10

as the foetal and maternal blood mixes during birth - we have to carry out a caesarean

Question 11

Why is the umbilical chord clamped?

Answer 11

to allow the baby circulation to maintain its own oxygenation

Question 12

What infectious diseases CAN be passed to babies at BIRTH?

Answer 12

HIV
HEP B
HEP C

Question 13

what chronic diseases should the mother be screened for during pregnancy?

Answer 13

HT

Diabetes

Question 14

what infectious diseases should the mother be screened for during pregnancy?

Answer 14

Rubella
Syphilis
HEP
HIV

Question 15

What is amniocentesis?

Answer 15

taking a sample of amniotic fluid from around the foetus, removing cells from the fluid and examining the genetic sequence within these cells.

Question 16

What foetal tests are carried out in trimester 1?

Answer 16

ultrasound
Papp-P
Maternal hCG

Question 17

What foetal tests are carried out in trimester 2?

Answer 17

Ultrasound
AFP

• follow up of abnormalities detected in T1

Question 18

What foetal tests are carried out at birth?

Answer 18

physical exam

hearing test

blood spot

APGAR

Question 19

What do we test for in a blood spot test at birth? (5)

Answer 19

CF
PKU
Congenital hypothyroidism 
sickle cell 
acyl coA dehydrogenase deficiency

Question 20

What does an APGAR test examine and when should it be taken?

Answer 20

@ 1 min
@ 5 min
= significant rise

A - activity = muscle tone

P - pulse > 100/min

G - grimace = reflex

A - appearance = colour

R - respiration rate

Question 21

What are the dental implications of pregnancy?

Answer 21

Free

Increased risk of gingivitis and periodontitis

Position mother on her side (pillow under her side)

drug interactions