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3rd Year - Reproductive Diseases > 1.1. Antenatal Care and Screening > Flashcards

1.1. Antenatal Care and Screening Flashcards

1
Q

What normal Physiological Changes (Minor Ailments) occur in a Pregnant Woman?

A
  1. Morning Sickness
  2. Palpitations
  3. Increased Urine Output
  4. Urinary Tract Infection
  5. Anaemia
  6. Dyspnoea
  7. Heartburn
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2
Q

Why do Palpitations occur?

A
  1. Palpitations - Due to an increased Cardiac Output

2. Decreased Blood Pressure in the 2nd Trimester

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3
Q

Why is there an increase in Urine Output, during Pregnancy?

A
  1. Renal Plasma flow increases by 25-50%
  2. Glomerular Filtration increases by 50%
  3. Bladder Capacity Reduced
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4
Q

Why are UTI’s more common in pregnancy?

A

Increase in Urinary Stasis so there is an easier path for ascending infection

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5
Q

Why does Anaemia develop during pregnancy?

A

Increased Iron Requirements for the Foetoplacental Unit

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6
Q

Why does Dyspnoea occur during pregnancy?

A

Progesterone acts centrally to reduce CO2 - increase in Tidal Volume - Increase in Respiratory Rate - Increase in Plasma pH

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7
Q

Why does Heartburn occur during pregnancy?

A
  1. Oesophageal Peristalsis is reduced
  2. Gastric Emptying slows
  3. Cardiac (Lower Oesophageal) Sphincter Relaxes
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8
Q

With regards to Pre-Pregnancy counselling, what can be done in Primary Care?

A
  1. General Health Measures - Diet / BMI / Alcohol
  2. Smoking Cessation advice
  3. Folic Acid - 400mcg / day
  4. Confirm Immunity to Rubella
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9
Q

What known Medical Problems are considered in Pre-Pregnancy counselling?

A
  1. Optimist Maternal Health - Diabetes / Epilepsy / Pre-Eclampsia / PKU / Thyroid
  2. Psychiatric health is important
  3. Stop / Change unsuitable drugs
  4. Advise regarding complications associated with Maternal Medical Problems
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10
Q

What Maternal Problems / Actions should be covered in Pre-Pregnancy Counselling?

A
  1. Caesarean Section
  2. Deep Vein Thrombosis
  3. Pre-Eclampsia

Actions taken:
Thromboprophylaxis - Low Dose Aspirin

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11
Q

What Foetal Problems / Actions should be covered in Pre-Pregnancy Counselling?

A
  1. Pre-Term Delivery
  2. Intrauterine Growth Restriction
  3. Foetal Abnormality

Actions Taken:

  1. Treatment of Infection
  2. High dose Folic Acid (400mcg / day)
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12
Q

What does an Antenatal Examination aim to identify in:

  1. The Mother?
  2. The Foetus?
  3. Social Factors?
A
  1. a) Pre-existing / Developing illness
  2. b) “Minor” problems (e.g. Anaemia)
  3. Foetal Abnormality / Small for Gestational Age
  4. Support / Domestic Violence / Psychiatric Illness
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13
Q

What is examined in an Antenatal Examination?

A
  1. Routine Enquiry - Feeling Well / Foetal Movements
  2. Blood Pressure
  3. Urinalysis
  4. Abdominal Palpation - Symphyseal Fundal Height / Size of the baby / Liquor Volume
  5. Foetal Presentation / Heartbeat
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14
Q

What Infections are Screened for in Antenatal Screening? And what are the treatments?

A
  1. Rubella
  2. Hepatitis B - provide passive / active immunisation for the baby
  3. Syphilis - treat with Penicillin
  4. HIV - Maternal treatment / careful planning
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15
Q

What, other than Infections, are screened for in Pregnancy?

A
  1. Iron Deficiency Anaemia
  2. Isoimmunisation:
  3. a) Rhesus Disease - Anti-D antibodies occur
  4. b) Anti-c / Anti-Kell
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16
Q

What is the purpose of the First Visit Scan?

A
  1. Ensure pregnancy is Viable
  2. See if there is Multiple Pregnancy
  3. Identify Abnormalities incompatible with Life
  4. Offer / Carry Out Down’s Syndrome Screening
17
Q

Does screening for Foetal Abnormalities tell for definite if their baby is affected?

A

No, it only provides a risk of their baby being affected.

Further testing will be offered to definitively tell if the baby is affceted

18
Q

When is the First Trimester Screening carried out?

A

10-14 weeks

19
Q

What is used in the First Trimester Sceening?

A
  1. Serum Beta-Human Choronic Gonadotrophin (Beta-hCG)
  2. Pregnancy associated Plasma Protein A (PAPP-A)
  3. Foetal Nuchal Translucency (NT) measurement
20
Q

What are the Foetal Nuchal Translucency (NT) measurement taken between?

A
  1. Crown Rump Lenghts of 45-84mm
  2. Increases with gestational age
    Note - incidence of Chromosomal Abnormalities is related to the Size, rater than the appearance of the Foetal Nuchal Translucency (NT) measurement
21
Q

What are the Further testing options for Down’s Syndrome?

A
  1. Chorionic Villous Sampling (CVS) (10-14 weeks)
  2. Amniocentesis (15 weeks +)
  3. Non-invasive Prenatal Testing (Maternal Bloods, for Foetal Cell Free DNA - Chromosomal Trisomies
    Note - Non-invasive Prenatal Testing is not offered by the NHS
22
Q

What is used to detect Neural Tube Defects?

E.g. Spina Bifida / Anenceohaly

A
  1. First Trimester Ultrasound
  2. Second Trimester Ultrasound
  3. Second Trimester Biochemical Screening
23
Q

What is the Purpose of the Second Trimester Ultrasound?

A

Detecting Foetal Abnormality

3rd Year - Reproductive Diseases (41 decks)

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