Pregnancy Risk Factors and Care Flashcards

1
Q

Common Pregnancy risk factors

A
  • BMI >30
  • Gestational weight gain
  • Smoking
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2
Q

Why is BMI>30 a pregnancy risk factor

A

Obesity puts the body in a pro-inflammatory state with endothelial cell dysfunction and vasoconstriction

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3
Q

Impact of BMI>30 on mother

A
  • HTN and endothelial dysfunction → GHTN and Pre-eclampsia
  • Antenatal → Miscarriage, GDM, VTE, OSA
  • Intrapartum → C-section, anaesthetic risk, PPH, difficulty monitoring fetal HR
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4
Q

Impact of BMI>30 on baby

A
  • LGA
  • Preterm birth
  • Sill birth/neonatal death
  • Shoulder dystocia
  • Long-term neonatal consequences (congenital abnormalities, neonatal body compositions, infant weight gain, obesity)
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5
Q

What is the role of the first Trimester scan?

A

4-13 week ultrasound can be used for
- Confirm viable pregnancy
- Confirm location (exclude ectopic)
- Dating using crown-rump length (If don’t know LMP)
- Gross fetal anatomy
- Detecting multiple pregnancies
- Nauchel translucency if doing screening for aneuploidy (chromosome abnormalities)

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6
Q

What screening is offered to all women in NZ?

A
  • 1st antenatal blood tests
  • Prenatal screening for aneuploidy
  • Anatomy scan at 18-20 weeks
  • 24-28 week blood tests (anaemia, iron, blood group, antibody screen, diabetes)
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7
Q

Prenatal screening for aneuploidy

A
  • Offered to ALL women but up to individual
  • Screening for abnormality of chromosomes (Trisomy 21 DS, Trisomy 18 and Trisomy 13)
  • 3 options available (2 funded and one not)
  • Funded = blood tests (9-13 weeks 6 days) and nuchal translucency scan at 11-13 weeks
  • Not funded = Non-invasive prenatal testing (6-7 weeks)
  • If +ve screening → Amniocentesis or CVS
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8
Q

What is the role of the 20-week anatomy scan?

A
  • Good at detecting defects in certain areas (Neural tube, urinary system, anterior abdominal wall)
  • More difficult to detect cardiac, facial, intestinal and minor skeletal abnormalities
  • However, some abnormalities are not present at this time of gestational not all structures are full developed
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9
Q

Why is this gestational age (20 weeks) chosen for the anatomy scan?

A
  • Developed such that we can see and check certain parts of anatomy and are growing as expected
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10
Q

What lab tests are recommended at the ‘booking’ appointment

A
  • Bloods (Hb, MCV, Platelet count, Blood group + antibodies, Rubella antibodies, Hep B+C, Syphilis, HIV, HbA1c)
  • Midstream Urine
  • STI swab
  • Cervical smear if due
  • USS to confirm date or if any sx
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11
Q

Why is regular antenatal care an important predictor of pregnancy outcome?

A
  • Monitors the progress of the pregnancy
  • able to identify any problems/new risks
  • revise the care plan
  • aim is to identify risk factors early and prevent/reduce the adverse effects of pregnancy complications
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12
Q

What does the antenatal care look like after the booking appointment?

A

Until 28 weeks = monthly visits with LMC
28-36 weeks = visits every 2 weeks
From 36 weeks = visits every week

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