8 - Pregnancy and perinatal health Flashcards
What can affect fertility?
- age
- smoking
- BMI
- exercise
- drugs
- folate
- alcohol
What occurs during the first trimester?
Tissue differentiation
What occurs during the second trimester?
Tissue specialisation
What occurs during the third trimester?
Growth
What are the different maternal changes that occur during pregnancy?
- physical
- hormonal
- haematological
- cardiovascular
- coagulation
What is the average weight gain for the mother during pregnancy?
11-16kg
What hormonal changes occur during pregnancy?
- increased oestrogen and progesterone (increased water retention, increased blood volume)
- hormonal changes reduce insulin sensitivity which leads to pregnancy diabetes
What haematological changes occur during pregnancy?
- increased production of RC, WC and platelets
- 20% increase in RC mass
- Hb appears low due to dilation bay increased blood plasma volume
What cardiovascular changes occur during pregnancy?
- relaxation of vascular smooth muscle (reduced peripheral resistance, reduced blood pressure = heart rate increases)
- vena cava and aorta compressed by uterus
- difficulty with venous return when supine, turn on side when in dental chair
What coagulation changes occur during pregnancy?
- clotting factor production increased
- fibrinolysis increased
- increased system sensitivity = DVT risk
What should pregnant women avoid eating?
- raw/slightly cooked fish and meat (infection)
- raw eggs (salmonella)
- non pasteurised milk and cheese (listeria)
- spicy, grilled and fired food (reflux)
- tuna and shark (mercury)
When does development begin?
- week 4
- zygote becomes embryo
When does embryonic circulation begin?
Week 6
When does an embryo become a foetus?
10 weeks
What is developing at week 14?
- hair
- nails
- eyelids
What is developing at week 18?
- toes and fingers formed
- hearing responds
What is developing at week 20-26?
- vision and other senses
- brain development
- body fat increases
What is developing at week 20-26?
- vision and other senses
- brain development
- body fat increases
What is developing at week 6-10?
Embryonic development and growth
What is developing at week 10-14?
- features
- limbs
When is the first trimester?
Conception - 14 weeks
When is the second trimester?
14 weeks - 27 weeks
When is the third trimester?
27 weeks - birth
What develops during the third trimester?
- growth
- nervous system maturation
- lungs
- muscle and fat reserves
What is the placenta?
- blood supply barrier between baby and mother
- blood supplies do not mix
- infection can cross
What are the stages of labour?
- induction
- 1st stage (degree of dilation)
- 2nd stage (degree of dilation)
- 3rd stage (delivery of placenta)
What screening occurs in the first trimester?
- establish dates of pregnancy
- number of foetuses and placental structures
- ectopic or miscarriage
- examine uterus and pelvic anatomy for delivery
- neuchal translucency
- PAPP-P and maternal hCG
What screening occurs at 18-20 weeks?
- foetal anatomy
- volume of amniotic fluid
- blood flow patterns
- observe foetal activity
- measure length of cervix
- monitor foetal growth
What screening occurs in the second trimester?
- AFP (alpha feto-protein)
- abnormality follow up ie amniocentisis or ultrasound
What screening occurs at birth?
- physical exam
- hearing test
- blood spot
What is tested for in the blood spot at birth?
- PKU
- hypothyroidism
- cystic fibrosis
- sickle cell disease
- MCADD
What is the APGAR score?
- tests baby’s responsiveness
- should greatly increase 1min to 5 mins
- activity, pulse, grimace, appearance, respiration
How does pregnancy affect dentistry?
- free dental care
- some drugs should be avoided in pregnancy
- pregnancy gingivitis is common
- positioning in chair
