Pregnancy

Question 1

Foetal complications associated with maternal obesity (3)

Answer 1

Congenital anomalies e.g. NTDs
Macrosomia (BW greater than 4500g)
Mortality

Question 2

Birth complications associated with maternal obesity (2)

Answer 2

Caesarean delivery

Shoulder dystocia

Question 3

Define GDM

Answer 3

Glucose intolerance with onset during pregnancy

Question 4

Define thromboembolism

Answer 4

Increased blood viscosity and upregulation of coagulation pathways

Question 5

Define shoulder dystocia

Answer 5

Delivery beyond the foetal head is obstructed by impaction of the foetal shoulders

Question 6

Define preeclampsia

Answer 6

Hypertension during pregnancy along with proteinuria

Question 7

Maternal complications associated with maternal obesity (3)

Answer 7

GDM
HDP
Thrombeomblism

Question 8

Why are demands for certain nutrients increased during pregnancy?(2)

Answer 8

Tissue deposition

Maintenance costs of pregnancy

Question 9

What increases maintenance costs of pregnancy?(2)

Answer 9

Increased BMR

Increase energy cost of PA

Question 10

What contributes to tissue deposition?(2)

Answer 10

Products of conception

Maternal tissues

Question 11

Products of conceptions (3)

Answer 11

Foetus
Amniotic fluid
Placenta

Question 12

Maternal tissues (4)

Answer 12

ECF
Uterus and breasts
Blood
Fat stores

Question 13

What is the optimal amount of weight gain during pregnancy?

Answer 13

12.5 kg

Question 14

Physiological adaptations to increase blood supply to the uterus (4)

Answer 14

Increased:
Blood volume
Cardiac output 
GFR
Renal plasma flow

Question 15

Why is an increased blood supply to the uterus needed?(2)

Answer 15

Nutrient supply to uterus

Sustain placental and foetal development

Question 16

Which hormone drives fat storage in 1st and 2nd trimesters

Answer 16

Progesterone

Question 17

Which hormone driving so fat mobilisation during the third trimester

Answer 17

Human placental lactogen

Question 18

How is nutrient supply to the foetus increase?(4)

Answer 18

Slower gastric emptying and intestinal transit
Increased absorption of some nutrients
Increased water absorption in colon
Increased insulin resistance

Question 19

Preeclampsia stage 1 (2)

Answer 19

Failure of spinal artery remodelling in placenta

Reduced perfusion of placenta

Question 19

Preeclampsia stage 2 (3)

Answer 19

Endothelial activation
Hypertension
Renal dysfunction

Question 20

Eclampsia

Answer 20

Maternal seizures

Question 21

Risks associated with GDM (6)

Answer 21

Perinatal mortality 
Preeclampsia 
Caesarian delivery 
NTDs
Macrosomia 
Neonatal hypoglycaemia

Question 22

Reduction of energy expenditure during pregnancy (3)

Answer 22

Reduced fat storage
Reduced PA
Improved energetic efficiency of PA

Question 23

Adolescent pregnancy risks (4)

Answer 23

Low both weight
Preterm birth
Intrauterine growth retardation
IDA

Question 24

Interventions for adolescents (3)

Answer 24

Iron and calcium supplementation | Extra protein

Question 25

Underweight (3)

Answer 25

BMI under 19.8 | Greater risk of preterm birth and low birth weight

Question 26

Overweight (4)

Answer 26

BMI over 26 Greater risk of diabetes and hypertension Should not attempt to lose weight

Question 27

Alcohol (3)

Answer 27

Ethanol freely crosses the placenta | Heavy drinking has a teratogenic effect

Question 28

Fetal alcohol syndrome (3)

Answer 28

Facial dysmorphology Growth restriction CNS anomalies

Question 29

Effects of low alcohol intake (3)

Answer 29

No strong evidence to suggest a negative effect Difficult to study due to ethics so it is unknown Variation in alcohol metabolism means safe levels differ between people

Question 30

Effects of caffeine intakes over 300 mg (2)

Answer 30

Increased risk of spontaneous abortion | Foetal growth restriction

Question 31

Conclusions of FSA caffeine study (2)

Answer 31

Difficult to set level of caffeine whee there is no risk | May be an increased risk in association with over 200mg

Question 32

Which enzyme for caffeine metabolism is absent in placenta and foetus

Answer 32

Cytochrome p450 1A2

Question 33

Nausea and vomiting (5)

Answer 33

Begins in 6th week of pregnancy Lasts for 6-8 weeks Women who vomited 17% lower risk of premature delivery 30% lower risk of miscarriage May be protective mechanism against toxins and teratogens

Question 34

Need for extra protein (3)

Answer 34

Protein synthesis increased for: Foetal growth Placentation Maternal tissues

Question 35

Why is an extra 800 mg of iron required (4)

Answer 35

Foetal liver stores Formation of placenta Expansion of blood volume Blood loss during delivery

Question 36

How are the extra iron requirements met?(3)

Answer 36

Increased iron absorption efficiency Cessation of menstrual iron losses Use of maternal stores

Question 37

How are extra protein requirements met (3)

Answer 37

Urinary nitrogen excretion decreases late in gestation In order to conserve amino acids Dietary protein utilisation increases

Question 38

Calcium requirements

Answer 38

Foetus required 30g

Question 39

How are calcium requirements met (4)

Answer 39

Maternal skeletal stores Results in loss of bones mineral density Increases intestinal absorption of dietary calcium This protects maternal calcium homeostasis

Question 40

Vitamin D requirement (2)

Answer 40

10 micro grams a day | Required to maintain calcium homeostasis