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MFSRH Part 1 CM > Pregnancy And Antenatal Care > Flashcards

Pregnancy And Antenatal Care Flashcards

(69 cards)

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1
Q

What 3 STIs are part of routine antenatal screening

A

HIV, STS, hep B

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2
Q

Why do vulval varices occur in pregnancy

A

Increased intra abdominal pressure

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3
Q

What happens to the glycogen content of the vaginal epithelium in pregnancy

A

Increases

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4
Q

Vaginal PH on pregnancy increase or decrease

A

Decrease

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5
Q

STIs linked to infertility or sub fertility

A

CT, GC, LGV

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6
Q

STIs most likely to affect early pregnancy

A

BV, STS, TV

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7
Q

STIs most likely to affect late pregnancy

A

HSV, CT, GC, STS, TV

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8
Q

Complications of BV

A

Prem membrane rupture (PROM)
Increased risk of uterine and wound infection
Preterm labour and birth
PP endometritis

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9
Q

Pregnancy BV tx

A

Metronidazole 400mg BD/TDS 5-7 days
Clindamycin 300mg BD 7 days
Increased complications with PV tx in preg

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10
Q

Does routine BV screening affect preterm birth rates

A

No

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11
Q

TV pregnancy complications

A

Low birth weight,
Preterm birth
PROM

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12
Q

VVC preg complications

A

None

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13
Q

Goal of VVC tx in pregnancy

A

Symptom management

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14
Q

Pregnancy PID complications

A

Low birth weight
Prem delivery
PROM
Chorioamnionitis
PP sepsis

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15
Q

CT vertical transmission rate

A

Up to 50%
Can spread at CS

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16
Q

Most common neonatal comp of CT

A

Conjunctivitis

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17
Q

CT in pregnancy tx

A

1g Azithromycin
Erythromycin 500mg BD 14 days/QDS 7 days
Amoxicillin 500mg TDS

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18
Q

GC preg complications

A

Low birth weight
Prem delivery
PROM
PP sepsis

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19
Q

GC intrapartum infection rate if untreated

A

30-50%

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20
Q

GC pregnancy tx

A

Ceftriaxone 1g IM
Spectinomycin 2g IM
Azithromycin 2g orally

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21
Q

HSV intrapartum transmission rate in primary infection

A

30-50%

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22
Q

Does CS negate HSV transmission risk

A

No, only reduce

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23
Q

How does STS transmit in pregnancy

A

Trans placentally

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24
Q

Complications of STS tx in pregnancy

A

Jarisch-Herxheimer reaction - can cause fetal distress/premature labour

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25
STS tx in pregnancy
Benzathine Penicillin 2.4 million units IM once/three times Exposure therapy required if mother allergic to penicillin
26
Complications of warts in pregnancy
1 in 400 chance of neonatal transmission (Causing juvenile respiratory papillomatosis)
27
Wart tx in pregnancy
Cryo 85% bi/trichloroacetic acid Surgery
28
Hep b vertical transmission risk
At birth only 90% if e antigen positive 10% if e antigen negative
29
Hep B in neonate prevention
Hep B immunoglobulin immediately after birth Hep B vaccine in 12 hours 3 more doses at 1,2,12 months
30
HIV in pregnancy modes of transmission
In utero, during delivery, breastfeeding
31
Maternal risk factors for hiv transmission in pregnancy
High viral load Low CD 4
32
Intrapartum risk factors for hiv transmission
Prolonged rupture of membranes in viral load >50 Vaginal delivery if viral load >50
33
Infant risk factors for hiv transmission
Prematurity Breastfeeding
34
Untreated HIV transmission rates
35% (15% breastfeeding)
35
When is HIV tx advised in trim 1
If CD4 <200 VL>100,000 Otherwise start by wk 24
36
HSV complications for the mother
Dissemination
37
HSV risk to neonate
Dissemination (70%) Significant morbidity and mortality Skin/eye/mucus membrane infection (30%)
38
Why is primary HSV so dangerous to neonate
Prolonged cervicitis High viral load No time for maternal antibodies to develop
39
Heart changes in pregnancy
12% enlargement Lateral displacement of apical beat Increased intracardiac volume (80ml)
40
Plasma volume increase in pregnancy
50%
41
How does estrogen contribute to increased blood circulation in pregnancy
Increased oestrogen stimulates renin angiotensin system, increasing aldosterone, increasing na+ reabsorption
42
Increased red cell percentage In pregnancy
30%
43
Cardiac output increase in pregnancy
40%
44
What causes increased cardiac output in pregnancy
Increased stroke volume and increased heart rate
45
Changes in BP in pregnancy
Slight drop in systolic Larger drop in diastolic Widened pulse pressure
46
What happens to vascular resistance in pregnancy
Decreases
47
Common heart murmur of pregnancy
Ejection systolic
48
Pregnancy ECG changes
15-20 degree left axis shift St segment depression T wave flattening
49
What is the effect of the hyperventilation of pregnancy
Mild respiratory alkalosis (CO2 breathed off)
50
What are the chances on pregnancy lung volumes
Increased tidal volume (Smaller inspiritory reserve, smaller expiratory reserve, smaller residual)
51
Effects on lung capacity in pregnancy
Decreased total capacity (No change in vital capacity, increase in inspiritory capacity, decrease in functional)
52
Why why is there increased acidity of stomach acid in pregnancy
Increase in production of gastrin increases stomach volume and acidity of secretions
53
What clotting factors increase in pregnancy
Fibrinogen and factor VIII +++ Factors VII, IX, X, XII +
54
What clotting factor is majorly reduced?
Factor XIII
55
Average weight gain in pregnancy
12.5kg
56
Base tissue of the placenta
Trophoblast
57
What is the chorion
Where the trophoblast is penetrated by fetal mesoderm
58
What does the embryonic body stalk become
Umbilical cord
59
Why does uterine atony cause pph
Terminal maternal arterioles lose their elastic reticulum - they can't clamp themselves
60
What cells produce hcg
Syncytiotrophoblast
61
What hormones share an alpha subunit?
LH, FSH, TSH, hCG (glycoprotein hormones)
62
Where is relaxin produced
Corpus luteum
63
What does the placenta use to make estrogens
DHEAS (comes from fetal adrenal glands)
64
What is Wharton's jelly derived from
Primary mesoderm
65
What is the umbilical vein in an adult
Ligamentum teres
66
What is ligamentum teres contained in
Falciform ligament
67
What is the only type of immunoglobulin that can cross the placenta
IgG
68
Would baby igM be diagnostic of congenital infection
Yes, igM cannot cross the placenta
69
What does hypersensitivity to GDF15 cause
Hyperemesis gravidarum

MFSRH Part 1 CM (15 decks)

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