Obs Flashcards
(52 cards)
What is hyperemesis gravidarum
Severe or persistent vomiting in pregnancy
How many women are affected by hyperemesis gravidarum
2% of pregnancies
Syx of hyperemesis gravidarum
Starts between 4-7 weeks - often resolves by 16wks
N+V any time in the day - may be constant
Fluid and electrolyte disturbance
Ketonuria
Nutritional deficiency + weight loss
What makes n+v more common in pregnancy
Primigravidae
Multiple pregnancy
Hx of past hyperemesis gravidarum
Younger maternal age
DDX of hyperemesis gravidarum
Hydatiform mole Pre-eclampsia GI infection, irritation, ulcer, appendicitis etc Torted ovarian cyst drug SE Raised ICP diabetes Bulimia nervosa
Management of vomiting in pregnancy
Ginger Wrist acupressure Rest Eat small regular meals High carbohydrate low fat meals Avoid foods / smells that trigger syx Antihistamines
Tx of hyperemesis gravidarum
Prochlorperazine
Cyclizine
Metoclopramide
If severe refer to hospital - fluid and electrolyte replacement + nutritional support.
Complications of hyperemesis gravidarum
Dehydration
Weight loss
Electrolyte disturbance
Ketosis
Rarely –> wernicke’s encephalopathy, central pontine myelinosis, spontaneous oesophageal rupture.
Can diabetic women have a vaginal birth?
Yes
Should be offered elective induction or CS after 38wks
Babies born to diabetic mothers are at risk of what after birth?
Neonatal hypoglycaemia
Monitor for 24 hrs after birth.
Diabetic mothers who breast feed are at an increased risk of _________
Hypoglycaemia
Average length of a pregnancy
40 weeks
280 days
Term = 38-42 weeks
Average cycle length
28 days
On what day of a 28day cycle does ovulation occur
14th day
How to calculate EDD from LMP
Date of LMP + 9m + 7d
If the cycle is >28d also add the difference between 28 and the cycle length.
Feature of past pregnancies which may be relevant to current pregnancy
Recurrent miscarriage Preterm delivery Early onset pre-eclampsia Abruption Congenital abnormalities Macrosomic baby Fetal growth restriction Unexplained stillbirth
What does gravida mean
The number of pregnancies - regardless how they ended
What does parity mean?
Number of births > 24 weeks - live or still
Pre-existing diseases which may impact pregnancy
Diabetes mellitus Hypertension Renal disease Epilepsy VTE disease HIV connective tissue disorders Myasthenia gravis Myotonic dystrophy
What impact may existing DM have on pregnancy
Marosomia Fetal growth restriction Congenital abnormality Pre-eclampsia Stillbirth Neonatal hypoglycaemia
What impact may hypertension have on pregnancy
Pre-eclampsia
What impact may existing renal disease have on pregnancy
Worsening renal disease
Pre-eclampsia
Fetal growth restriction
Preterm delivery
What impact may existing epilepsy have on pregnancy
Increased fit frequency Congenital abnormality (medication)
What impact may existing VTE disease have on pregnancy
Increased risk of VTE in pregnancy
