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BDS3 BAMS > Pregnancy and Perinatal health > Flashcards

Pregnancy and Perinatal health Flashcards

1
Q

What are factors for fertility issues?

A
  • Age
  • Smoking
  • High BMI
  • Exercise
  • Drugs
  • Folate levels
  • Alcohol levels
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2
Q

What is spina bifida related to a low level of?

A
  • Low level of folic acid
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3
Q

What is foetal alcohol syndrome?

A
  • Group of conditions that can occur in a person who was exposed to alcohol before birth
  • Physical or neurological condition
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4
Q

When does the fertilised zygote implant into the uterus?

A
  • Approx day 8/9
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5
Q

How are the weeks someone is pregnant for divided?

A

First trimester - 6-12 weeks
Second trimester - 24weeks
Third trimester - 25-40 weeks

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6
Q

What maternal changes occur in pregnancy?

A
  • Physical changes
  • Hormonal changes
  • Haematological changes
  • Cardiovascular changes
  • Coagulation changes
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7
Q

What is the total weight gain of mother during pregnancy?

A

Approx 11-16kg
- Extra blood vol produced as lost will be lost during lost and protects mother against hypovolemia

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8
Q

How do the oestrogen and progestogen levels change in pregnancy and what do they do?

A
  • Both are increased
  • Act on kidney ot increase Renin secretion
  • Increased salt and water retention
  • Increased plasma vol by 45%
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9
Q

How does increased plasma vol protect against haemorrhage at birth?

A
  • Dilution effect makes HB fall from 15-12g/dL
  • But Hb carried in blood is still high as higher circulating plasma vol
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10
Q

What happens to the lower oesophageal sphincter during pregnancy?

A
  • Relaxes
  • As increase abdominal pressure gives increased GORD (Gastro-oesophageal reflux disease)
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11
Q

What do women with type 2 need to be careful of during pregnancy?

A
  • Hormonal changes increase
  • This reduces insulin sensitivity
  • Result in larger heavier baby that can cause complications during delivery
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12
Q

What happens to the vascular smooth muscle during pregnancy?

A
  • They become more relaxed
  • Reduced peripheral resistance
  • Reduces systolic and diastolic blood pressure
  • Compensatory increase in heart rate by 25%
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13
Q

What happens to the vena cava and aorta during pregnancy?

A
  • Vena cava and aorta lies behind uterus
  • Vascular compression by uterus leads to difficulty with venous return when mother is lying supine in dental chair
  • Let mother sit slightly to one side and propped to prevent vascular compression
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14
Q

What happens to coagulation screens during pregnancy?

A
  • Remain normal
  • Clotting factor production increases
  • Fibrinolysis increases
  • Increased system sensitivity leads to increased DVT risk which can cause problems in birth
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15
Q

What foods can pregnant women not eat?

A
  • Raw/ slightly cooked meat and raw fish due to danger of infection with toxoplasmosis
  • Raw eggs due to salmonella risk
  • Non pasteurised milk and cheese due to listeria risk
  • Spicy, grilled or fried food due to dyspepsia
  • Marlin, tuna, shark due to mercury toxicity
  • Liver and other internal organs of slaughtered animal during first three months of pregnancy
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16
Q

What occurs at week 4 of pregnancy?

A
  • Developmental starts at week 4
  • Zygote becomes an embryo
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17
Q

What occurs at week 6 of pregnancy?

A
  • Start of embryonic circulation
  • Weeks 6-10 embryonic development and growth
18
Q

What occurs at week 10 of pregnancy?

A
  • Embryo stops at 10 weeks
  • Foetus 10-14 weeks
  • Features and limbs become developed and active
19
Q

When is miscarriage most likely to happen?

A
  • Highest in first trimester due to abnormality in developmental stage and it is not compatible for life
  • Can happen anytime
20
Q

What specialised tissue occurs from week 14?

A
  • Hair
  • Nails and toenails
  • Eyelids start to form
  • Movement may be felt
21
Q

What specialised tissue forms at week 18?

A
  • Toes and fingers
  • Hearing starts to respond
22
Q

What specialised tissue forms at week 20-26?

A
  • Development of vision and senses
  • Brain development and body fat increase
23
Q

What occurs during third trimester form week 27?

A
  • Growth and nervous system maturation
  • Build up fat reserves ready for trauma birth
24
Q

What is the placenta?

A
  • Disc of tissue that connects mothers uterus to umbilical cord
  • Largely vascular
  • Responsible for delivering nutrients and oxygen to foetus
  • Baby doesn’t receive HIV if mother has it due to placenta barrier (will get HIV at birth therefore C-section done)
25
Q

What are the stages of Labour?

A
  • Induction of labour (when 10cm dilated)
  • First stage (delivery of baby)
  • Second stage (delivery of baby)
  • Third stage (delivery of placenta)
26
Q

What instruments can be used to help labour?

A
  • Forceps (don’t touch the child)
  • Ventoux
  • Caesarean section
27
Q

What happens to the umbilical cord after birth?

A
  • It is clamped
  • Allows baby to maintain own oxygenation
  • Vessels get no oxygenation, allows stump to become necrotic and fall off
28
Q

How is the screening of the first trimester used to provide info for the mother?

A
  • Establish dates of pregnancy
  • Determine number of foetuses and identify placental structures
  • Diagnose ectopic pregnancy or miscarriage
  • Examine uteruses and other pelvis anatomy for potential problems in delivery
  • Some cases detect foetal abnormalities (genetic or developmental)
  • Chronic or infectious diseases of Mother (Hep B/C HIV)
29
Q

What Chronic diseases are screened for?

A
  • Hypertension as this can cause condition called preeclampsia
  • Diabetes
30
Q

What infectious diseases are being screen for?

A
  • Rubella
  • Syphilis
  • Hep C
  • HIV
31
Q

What is preeclampsia?

A
  • Condition that causes high blood pressure during pregnancy and after labour
  • Can be serious if not treated
32
Q

What does the detailed screening exam look for that happens at 18-20 weeks?

A
  • Confirm pregnancy dates
  • Determine number of foetus and examine placental structures
  • Examine anatomy for abnormalities
  • Check amniotic fluid
  • Examine placenta
  • Examine blood flow patterns
  • Monitor foetal growth
33
Q

What is FAST?

A
  • Foetal abnormality screening programme
34
Q

In the first trimester what does FAST screen for?

A
  • Neuchal translucency via ultrasound
  • Maternal hCG via bloods
  • PAPP-P via blood
  • Combined results can suggest chromosome abnormality
35
Q

In the second trimester what does FAST screen for?

A
  • AFP
  • Abnormality follow up of previous tests
  • CVS and amniocentesis for genetic changes
  • Ultrasound for spina bifida
36
Q

When is birth testing taken place?

A
  • Incredible soon after birth
37
Q

What occurs during the birth testing?

A
  • Physical examination
  • Hearing test

Blood spot
- Phenylketonuria (PKU)
- Hypothyroidism
- Cystic fibrosis
- Sickle cell disease
- MCADD (acyl CoA dehydrogenase deficiency)

38
Q

What is the APGAR score?

A
  • Used to determine assertiveness of baby 1min after birth and 5 mins after birth
  • Should be a significant rise between the two
39
Q

What is monitored in the APGAR score?

A

A - Activity (muscle tone)
P - Pulse (>100/min)
G - Grimace (Reflex irritability)
A - Appearance (colour)
R - Respiration (rate)

If low then transported to special care unit

40
Q

What are some things we need to consider with pregnant women during pregnancy?

A
  • Free dental care
  • Be aware drugs can pass on to baby
  • Pregnancy gingivitis
  • Periodontal health in pregnancy
  • Position of mother on chair

BDS3 BAMS (15 decks)

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