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Repro > 4 - Antenatal Care - Pre-pregnancy Counselling > Flashcards

4 - Antenatal Care - Pre-pregnancy Counselling Flashcards

1
Q

name 4 general health measures for mothers?

A

improve diet

optimise BMI

decrease alcohol consumption

smoking cessation

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2
Q

ideal scenario for smears?

A

to have up to date cervical smear

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3
Q

how does age play a role in healthcare for mothers?

A

teenagers and older mothers are at risk -

teenagers - not as engaged etc.

older - prone to more complications e.g. gestational diabetes, hypertension

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4
Q

relationship between preeclampsia and parity?

A

preeclampsia will usually appear during 1st pregnancy

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5
Q

define grand multiparity?

A

4+ deliveries of labour

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6
Q

risks of grand multiparity

A

post-partum haemorrhage

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7
Q

describe a specific occupational hazard to be avoided by mothers as it can increase the risk of anomalies?

A

chemicals - e.g. lab based work etc.

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8
Q

2 types of medications to be avoided while pregnant?

A

ACE-Is

Sodium Valproate

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9
Q

what is sodium valproate usually used for?

A

to control epilepsy

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10
Q

what are the risks of taking sodium valproate while pregnant?

A

increased risk of spina bifida

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11
Q

in terms of diabetes, when is pregnancy not advised?

A

when HbA1c is increased

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12
Q

what is a common problem associated with hyperthyroidism during pregnancy?

A

Grave’s disease

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13
Q

what is the effect on hypothyroid mothers when pregnant?

A

they need to increase their dose of thyroxine

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14
Q

name 3 increased risks for diabetic mothers?

A

pre-eclampsia

still birth

macrosomic infant

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15
Q

name 2 things which increase the risk of pre-eclampsia?

A

proteinuria

hypertension

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16
Q

what does renal transplant restore? (2)

A

renal function

fertility

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17
Q

how are previous pregnancies useful?

A

they are a good indicator on how current pregnancy will progress

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18
Q

choosing a delivery - what does 1 previous C-section indicate?

A

it is possible to trial labour or get a C-section

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19
Q

choosing a delivery - what does 2 previous C-sections indicate?

A

elective C-section again

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20
Q

describe 2 maternal measures that are taken in case of pre-eclampsia?

A

150 mg aspirin during pregnancy

regular BP monitoring

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21
Q

describe 2 maternal measures that are taken in case of gestational diabetes?

A

take HbA1c @ booking

OGTT @ 28 weeks

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22
Q

describe maternal considerations in case of DVT/ PE?

A

antenatal thromboprophylaxis + 6 weeks postnatal treatment

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23
Q

describe 2 measures that are taken in case of foetal intrauterine growth?

A

aspirin 150mg during pregnancy

serial US scans

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24
Q

describe a consideration in case of preterm birth?

A

transvaginal cervical length scans/ cervical suture

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25
Q

6 things to check for in maternal antenatal examination?

A

pre-existing conditions

increased BP

anaemia

urinalysis

mental health

birth planning

26
Q

6 things to check for in foetal antenatal examination?

A

screening

decreased foetal movements

malpresentation

size

abnormalities

HR

27
Q

5 things which are measured during antenatal examination?

A

SFH

size of baby

liquor volume

HR

presentation and lie of the body

28
Q

what is SFH?

A

symphyseal fundal height

29
Q

what is liquor volume used for?

A

to gauge foetal weight

30
Q

what is normal liquor volume @ 12 weeks?

A

60 mL

31
Q

what is the best presentation and lie for the baby?

A

vertex longitudinal

32
Q

define screening?

A

testing of symptomless population to detect cases of a disease @ early stage & variety of tests are offered

33
Q

screening for infection - name 4 things which are screened for?

A

Hep B

Syphilis

HIV

UTI

34
Q

how is syphilis treated?

A

penicillin

35
Q

if Hep B is present, what is effect on baby?

A

provides baby with passive & active immunisation or can be present as chronic carrier state

36
Q

name 5 side effects of syphilis on the foetus?

A

intrauterine growth restriction

hepatosplenomegaly

anaemia

thrombocytopenia

skin rashes

37
Q

define thrombocytopenia?

A

condition characterized by abnormally low levels of platelets (thrombocytes) in the blood

38
Q

how is UTI screened for in mother?

A

MSSU - Mid Stream Specimen Urine

39
Q

what type of anaemia is commonly screened for?

A

Iron deficiency anaemia

40
Q

in terms of isoimmunisation, what causes anaemia?

A

increased red cell antibodies

41
Q

what is offered in the interest of preventing rhesus disease in baby?

A

All Rhesus D -ve women are offered anti-D @ 28 weeks

42
Q

which Rhesus D -ve women are most at risk of passing on rhesus disease to their baby?

A

Rhesus D -ve women with rhesus +ve partner

43
Q

describe 4 key things which occur @ 1st visit scan?

A

ensure pregnancy is viable

multiple pregnancy

offer of Down’s syndrome screening

trisomy 18 screening

44
Q

when does 1st visit scan typically occur?

A

11-14 weeks

45
Q

trisomy of which chromosome results in Down’s?

A

trisomy 21

46
Q

what is considered high risk of down’s syndrome?

A

1/150

47
Q

what is average risk of down’s syndrome?

A

1/700

48
Q

what is the risk of down’s syndrome in mother of 45yrs?

A

1/30

49
Q

what are 2 risk factors for chromosomal abnormalities?

A

FH of chromosomal abnormality

personal history of chromosomal abnormality

50
Q

what is Nuchal translucency scan used for and how is it taken?

A

used to detect chromosomal abnormalities, cardiac defects and many genetic syndromes

sonographic appearance of a collection of fluid under the skin behind the fetal neck - taken between the Crown Rump Length’s of 45-84mm

51
Q

Name 2 instances when Nuchal translucency scan cannot be taken?

A

Maternal BMI

Foetal position

52
Q

describe 4 things which are biochemically screened for @ 2nd scan visit?

A

hCG

unconjugated oestrodiol

alpha-feto protein

inhibin-A

53
Q

at which value is Alpha-fetoprotein considered a risk and why?

A

> 2.0 MoM - this is increased risk of foetal abnormality

54
Q

give 2 examples of conditions which could be indicated by increased alpha-fetoprotein?

A

Spina Bifida

Exomphalos

55
Q

describe 3 possible next steps if there is an increased risk from biochemical screening?

A

CVS

Amniocentesis

Non-invasive prenatal testing

56
Q

when is CVS carried out?

A

10-14 weeks

57
Q

what is the risk of CVS?

A

1-2% miscarriage

58
Q

when is amniocentesis carried out?

A

15 weeks

59
Q

what is the risk of amniocentesis?

A

~1% risk of miscarriage

60
Q

what is US scan used for and what does it show?

A

to detect foetal abnormalities - POOR test for chromosomal abnormalities

Repro (28 decks)

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