2 - Obs - Antenatal Care - Minor Conditions of Pregnancy

Question 1

physiology changes in pregnancy

• weight change?
• lungs?
• thyroid?
• gut?

Answer 1

increased wt by 10-15kg

tidal volume increases but RR has no change

thyroid enlargement

gut motility reduced - delayed emptying

Question 2

physiology changes in pregnancy

• Renal?
• genital tract?

Answer 2

glom filtration rate increase -> so creatinine/urea decreases

uterus weight - 50>1000g
muscle hypertrophy, incr bl fl and contractility
cervix softens

Question 3

physiology changes in pregnancy

-Blood?

Answer 3

50% incr in bl volume
incr red cell mass
Hb decreased
WBC increase

Question 4

Pregnancy may cause pain in different parts of the body - what conditions?

Answer 4

pelvic girdle pain
abdo pain
heartburn
backache
leg cramps
carpel tunnel

Question 5

Pregnancy may cause other minor conditions - what are they?

Answer 5

tiredness
vaginitis
itching
constipation
ankle oedema

Question 6

itching - what must be checked/assessed? what are rare but present with itching?

Answer 6

liver problems rare in preg but presx with itching

must check sclera, LFTs and bile acids

itching is common in preg

Question 7

pelvic girdle pain - where is pain? trt?

Answer 7

pubic and sacroiliac joints

physio corsets, analgesia and even crutches may be used

Question 8

abdo pain - what conditions especially, may have worse prog in pregnancy? what two things can cause abdo pain in preg?

heartburn - how common? worst in what pos? what helps? trt? what can present with epigastric pain?

Answer 8

pancreatitis and appendicitis

UTIs and fibroids

70% - supine
extra pillows
antacids not CI’d, ranitidine used in severe
preeclampsia

Question 9

Backache - common? may cause what? what may help?

Answer 9

almost universal
may cause sciatica
physio, posture+lifting advice, firm mattress and corset

Question 10

Ankle oedema - unreliable sign of? sudden incr warrants what? trt?

Answer 10

preeclampsia

full assessment and follow up of BP and urinalysis

raising feet - diuretics not given

Question 11

carpal tunnel - due to? severity? trt?

Answer 11

fluid retention compressing median nerve
seldom severe, usually temp
wrist splints

Question 12

Vaginitis - due to? Sx? trt?

Answer 12

candidiasis common in preg
itchy, non-offensive white-grey discharge with excoriation
imidazole vaginal pessaries used for Sxatic infection