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Repro and Sexual Health > Week 4 > Flashcards

Week 4 Flashcards

(38 cards)

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1
Q

Which anti-emetic is used in pregnancy?

A

Cyclizine

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2
Q

List some complications of pre-eclampsia

A
  • Eclampsia
  • HELLP Syndrome
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3
Q

What does HELLP stand for?

A

Haemolysis
Elevated Liver enzymes
Low Platelets

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4
Q

How can HELLP Syndrome be managed?

A

This condition can only be treated by delivery of the baby, hence ASAP

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5
Q

When is HELLP Syndrome most likely to occur?

A

Immediately after the baby is delivered

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6
Q

What is the triad of symptoms of pre-eclampsia?

A
  1. Hypertension
  2. Proteinuria
  3. Oedema
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7
Q

What do you give as prophylaxis of pre-eclampsia?

A

Aspirin (150mg) from 12 weeks until birth

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8
Q

When during pregnancy does gestational hypertension usually develop?

A

During the second trimester

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9
Q

What are some of the reasons for a baby being Large for Dates?

A
  1. Fetal macrosomia
  2. Multiple pregnancy
  3. Wrong dates
  4. Polyhydramnios
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10
Q

What is the management of Large for Dates?

A
  1. Exclude diabetes
  2. Reassure
  3. Conservative vs IOL vs C section
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11
Q

Define Polyhydramnios

A

Excess amniotic fluid

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12
Q

What is the normal range of Symphysial Fundal Height?

A

Within 2cm on either side of how many weeks along she is

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13
Q

What are some aetiologies of Polyhydramnios?

A
  1. Maternal
    • diabetes
    • red cell antibodies
  2. Fetal
    • twin or multiple pregnancy
  3. Idiopathic
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14
Q

How heavy must a newborn be to be classed as large for gestational age?

A

4.5kg
During pregnancy it is above 90th centile

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15
Q

How does obstetric cholestasis present?

A
  • During the 2nd half of pregnancy
  • severe pruritus
    • (no rash present)
    • Particularly on the palms and soles
  • Very very dark urine, anorexia and steatorrhea
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16
Q

Why do you carry out a left lateral tilt

Study These Flashcards
A

Left-lateral tilt position is used to reduce assumed aortocaval compression by the pregnant uterus

17
Q

At the booking scan an USS is carried out, in this the Crown Rump Length and Nuchal Translucency. What does Crown Rump Length indicate?

Study These Flashcards
A

Indicates the gestation
Plotted on a graph

18
Q

At the booking scan an USS is carried out, in this the Crown Rump Length and Nuchal Translucency. What does Nuchal Translucency indicate?

Study These Flashcards
A

It’s diameter indicates the 3 trisomies and an increased NT could be an early sign/link to a structural abnormality or hydrops

19
Q

From when can CVS be carried out?

20
Q

From when can amniocentesis be carried out?

21
Q

If the booking scan is missed, how can you test for trisomy 13, trisomy 18, and trisomy 23

Study These Flashcards
A

Down’s Syndrome can be tested for on a blood test
Trisomy 13 and Trisomy 18 can be seen on the 20 week scan

22
Q

What is the definitive test for Down’s Syndrome, trisomy 13 and Trisomy 18?

Study These Flashcards
A

NIPT (Non-Invasive Prenatal Testing)

23
Q

Name 2 abdominal wall defects that can be screened for antenatally?

Study These Flashcards
A
  1. Gastrochisis
  2. Exomphalos
24
Q

Define Gastrochisis

Study These Flashcards
A

Gastroschisis is a defect of the abdominal wall, which results in your baby’s bowel being outside of their tummy. This means the bowel is not protected by any membrane or sac.

25
Define Exomphalos
Gastroschisis is a defect of the abdominal wall, which results in your baby's bowel being outside of their tummy. This means the bowel is not protected by any membrane or sac. Exomphalos is a defect at the base of the umbilical cord. It causes the bowel to push through (herniate) into the umbilical cord.
26
Which abdominal wall defect, gastrochisis or exomphalos, is more dangerous and why?
Exomphalos is more dangerous because these babies almost always have other problems e.g. chromosomal defects or structural abnormalities
27
When is magnesium sulfate used antenatally?
- Prevention of seizures in pre-eclampsia - Treatment of seizures and prevention of seizure recurrence in eclampsia - Neuroprotection of neonate [in established preterm labour or planned preterm birth within 24 hours]
28
When is pre-eclampsia defined as Eclampsia?
When a woman with pre-eclampsia has at least 1 seizure
29
What antihypertensives can be used for hypertension in pregnancy?
- Labetalol - Methyldopa - nifedipine
30
Management of severe PET/Eclampsia
1. Control BP: anti-hypertensives - IV Labetalol - IV Hydralazine 2. Stop/prevent seizures - magnesium sulfate for 24hrs - loading dose - maintenance dose: IV infusion 1g/h - if further seizures administer: 2-4gMg SO4 3. Fluid balance 4. Delivery
31
What are some factors that make you high risk for pre-eclampsia?
- current hypertension - hypertension during a previous pregnancy - CKD - autoimmune diseases e.g. SLE or APS - T1DM or T2DM
32
Is gestational diabetes likely to recur?
Rate of recurrence is high
33
What are some indications that high dose folic acid should be given?
- Coeliac disease (because of the restricted diet) - Sickle cell anaemia or thalassaemia - diabetes - BMI > 30 - anticonvulsants (for epilepsy) - previous pregnancy affected by spina bifida, anencephaly, heart or limb defects and some childhood brain tumours and anaemia
34
When and how much folic acid should be given for women trying to conceive/pregnant?
400mcg from before conception to 12 weeks
35
What can deficiency in folic acid cause?
Neural Tube Defects (NTDs) e.g. Anencephaly, Spina Bifida
36
Which vitamin is neurotoxic to the fetus in high doses?
Vitamin A Hence no supplementation and no liver (as it is high in it)
37
Why is listeria dangerous in pregnancy?
Listeria monocytogenes infection can cause in utero infection. This can cause miscarriages, stillbirths and preterm labour
38
If a woman has a seizure during labour, what is the first line management?
Benzodiazepines

Repro and Sexual Health (7 decks)

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