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Haematology > obstetric haematology > Flashcards

obstetric haematology Flashcards

(48 cards)

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1
Q

describe the 4 chains in normal haemoglobin

A

2 alpha chains and 2 non-alpha chains

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2
Q

describe the 4 chains in normal haemoglobin

A

2 alpha chains and 2 non-alpha chains

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3
Q

what is the role of globin in haemoglobin

A

protects haem from oxidation
renders the molecule soluble
permits variation in oxygen affinity

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4
Q

what is the percentage of Hb-A in normal adult /hb

A

> 95%

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5
Q

what is the percentage of Hb-A2 in normal adult Hb

A
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6
Q

which testing is offered to high risk pregnancies following antenatal screening?

A

chorionic villus biopsy and genetic diagnosis at 8-12 weeks

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7
Q

how does pregnancy affect the RBC MCV

A

MCV increases physiologically
pregnancy increased folic acid requirements
iron requirements increase but this usually results in considerable mobilisation of iron stores

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8
Q

what happens to the plasma volume in pregnancy

A

plasma volume expands by 50%

haemodilution occurs maximally at 32 weeks

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9
Q

how much does the RCM expand in pregnancy

A

25%

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10
Q

define anaemia in the 1st and 3rd trimester

A

Hb

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11
Q

define anaemia in the 2nd trimester

A

Hb

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12
Q

what is the most common cause of anaemia in pregnancy

A

iron deficiency

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13
Q

what happens to WBC count in pregnancy

A

leucocytosis (increase in WBCs)

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14
Q

which WBC increases in number the most

A

neutrophilia

peak range around 9-15 in 2nd-3rd trimester

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15
Q

describe the left shift that may be seen

A

myelocytes/ metamyelocytes

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16
Q

what happens to the platelet count in pregnancy

A

thrombocytopenia

usually >70x109/L

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17
Q

when does the platelet count fall and when is thrombocytopenia most marked?

A

after 20 weeks starts to fall

most marked in late pregnancy

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18
Q

what is the effect of thrombocytopenia

A

no pathological significance for mother or foetus
recovers rapidly following delivery
main issue in management is differentiation from other causes

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19
Q

what are the consumptive causes of pregnancy associated thrombocytopenia

A 
gestational
pre-eclampsia and HELLP syndrome
AFLP
DIC 
TTP/HUS
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20
Q

what are the consumptive causes of pregnancy associated thrombocytopenia

Study These Flashcards
A 
gestational
pre-eclampsia and HELLP syndrome
AFLP
DIC 
TTP/HUS
21
Q

what are the coincidental consumptive causes of thrombocytopenia

Study These Flashcards
A 
ITP
viral (HIV/ EBV)
sepsis
type 2B vWD
hypersplenism
22
Q

what is the percentage of Hb-A in normal adult /hb

23
Q

what is the percentage of Hb-F in normal adult Hb

24
Q

which testing is offered to high risk pregnancies following antenatal screening?

Study These Flashcards
A

chorionic villus biopsy and genetic diagnosis at 8-12 weeks

25
how does pregnancy affect the RBC MCV
MCV increases physiologically pregnancy increased folic acid requirements iron requirements increase but this usually results in considerable mobilisation of iron stores
26
what happens to the plasma volume in pregnancy
plasma volume expands by 50% | haemodilution occurs maximally at 32 weeks
27
how much does the RCM expand in pregnancy
25%
28
define anaemia in the 1st trimester
Hb
29
define anaemia in the 2nd trimester
Hb
30
what is the most common cause of anaemia in pregnancy
iron deficiency
31
what happens to WBC count in pregnancy
leucocytosis (increase in WBCs)
32
which WBC increases in number the most
neutrophilia | peak range around 9-15 in 2nd-3rd trimester
33
describe the left shift that may be seen
myelocytes/ metamyelocytes
34
what happens to the platelet count in pregnancy
thrombocytopenia | usually >70x109/L
35
when does the platelet count fall and when is thrombocytopenia most marked?
after 20 weeks starts to fall | most marked in late pregnancy
36
what is the effect of thrombocytopenia
no pathological significance for mother or foetus recovers rapidly following delivery main issue in management is differentiation from other causes
37
what are the pregnancy associated production causes of thrombocytopenia
production failure due to severe folate deficiency
38
what are the consumptive causes of pregnancy associated thrombocytopenia
``` gestational pre-eclampsia and HELLP syndrome AFLP DIC TTP/HUS ```
39
what is the productive coincidental cause of thrombocytopenia
bone marrow infiltration/ hypoplasia
40
what are the coincidental consumptive causes of thrombocytopenia
``` ITP viral (HIV/ EBV) sepsis type 2B vWD hypersplenism ```
41
what happens to coagulation in pregnancy
pregnancy is a pro-thrombotic state
42
what happens to platelet activation
increases in pregnancy
43
what happens to coagulation factors
increase in many procoagulant factors | reduction in some natural anticoagulants
44
is there an increase of decrease in fibrinolysis
decrease
45
which coagulation factors are increased
fibrinogen, thrombin, factor V, VIII, X, XII
46
what happens to the level of vWF
great increase in vWF than FVIII
47
how do levels of FIX and FXI change
minimal increase in FIX and decrease in FXI
48
how does FXIII change
initial increase followed by reduction to approx. 50% non pregnant value

Haematology (5 decks)

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