Musculoskeletal Conditions

Question 1

Why do MSC develop in pregnancy?

Answer 1

-more progesterone and relaxin causing joint laxity
-gravies uterus affecting posture
-increased body mass placing pressure on spine

Question 2

Carpal tunnel syndrome definitions and symptoms

Answer 2

-compression of median nerve in carpal tunnel
-risk increases X15 in pregnancy
-caused by increased progesterone increasing oedema which compresses nerve
-numbness and pain

Question 3

Pelvic girdle pain definition, symptoms and treatment

Answer 3

-affects 1:5 pregnant women (RCOG, 2015)
-pain affecting pelvis and hips caused by relaxin causing uneven movements of joints
-physio referral, analgesia, baths, avoid lifting heavy objects

Question 4

Define spinal cord injury (SCI)

Answer 4

Damage to spinal cord resulting in change to its motor, sensory function

Question 5

Pre-conception care for women with SCI

Answer 5

-specialist clinic
-plan to conceive once rehab has taken place
-signpost to groups for families with SCI,etc

Question 6

Antenatal care of women with SCI

Answer 6

—consultant led care
-aim for vaginal birth unless injury states otherwise
-assess for VTE
-consider perception of pain and FM

Question 7

Intrapartum care for women with SCI

Answer 7

-consider catheterisation
-analgesia is required even if no perception of pain
-CTG
-Obstetric care

Question 8

What is autonomic dysreflexia

Answer 8

-sudden onset of high BP
-headache, nausea, anxiety
-compare BP to THEIR baseline
-associated with bradycardia

Question 9

Postnatal care for women with SCI

Answer 9

-if injury is above T4, may require nasal oxytocin as neural breast to brain pathway may be affected

Question 10

Contraceptive care for women with SCI

Answer 10

Avoid oestrogen products as can alter blood clotting factors leading to risk of VTE

Question 11

Ehlers Danlos syndrome definition, symptoms and treatment

Answer 11

-genetic collagen disorder
-hypermobility, joint pain, dizziness
-physiotherapy, occupational therapy
-may opt for genetic counselling
-higher risk of PGP, malposition, precipitate birth

Question 13

Rheumatoid arthritis definition, symptoms and treatment

Answer 13

-immune system attack joints resulting in inflammation and pain
-reduced mobility
-once pregnant, medication suitability should be checked
-pregnancy could reduce or increase symptoms

Question 14

Lupus definition, symptoms and treatment

Answer 14

-immune system produces antibodies that attack healthy cells
-more common in BAME
-rash, pain, hair loss
-NSAIDS main treatment which isn’t compatible with pregnancy
-advised to get pregnant after 6 month recession

Question 15

AN and NC for women with lupus

Answer 15

-cLC, serial growth scan and antibody blood tests and lupus increases risk of IUFD, and FGR
-baby may develop lupus syndrome which causes heart block and liver abnormalities as maternal antibodies cross the placenta

Question 16

Anti phospholipid (APL) syndrome definition, symptoms and treatment

Answer 16

Produces APL antibodies which attaches to fat molecules causing blood to clot
-bone necrosis, arthritis, fractures
-2% pregnant women affected
-anti coagulation to stop blood clots