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Midwifery > Antenatal > Flashcards

Antenatal Flashcards

Anaemia, bloods, weight gain, nutrition, screening

1
Q

What is the recommended iodine supplementation dose for pregnancy?

A

150mcg PO a day

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2
Q

When should a woman take iodine supplementation?

A

When pregnant and breastfeeding

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3
Q

Why should a woman take iodine supplementation during pregnancy?

A

To help the fetal body grow and development, especially the brain

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4
Q

What are the consequences of low iron in pregnancy?

A

Can lead to hypothyroidism that can cause congenital anomalies and decreased fetal intelligence

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5
Q

What is the recommended folic acid supplementation in pregnancy?

A

800mcg PO a day

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6
Q

When should a woman take folic acid supplementation?

A

Four weeks before pregnancy through to 12 weeks gestation

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7
Q

Why is folic acid supplementation recommended in pregnancy?

A

To help prevent neural tube defects like spina bifida

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8
Q

What are the consequences of low folic acid in pregnancy?

A

Increases the risk of neural tube defect e.g. spina bifida

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9
Q

What is the recommended iron supplement dose in pregnancy?

A

27 mcg / 200mg PO once or twice a day depending on ferritin levels

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10
Q

The purpose of ordering Ferritin level in early pregnancy is to establish the baseline indication of:

A

Iron stores

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11
Q

Why is iron supplementation recommended in pregnancy?

A

For growth and development as the baby uses the maternal iron to make haemoglobin

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12
Q

What are the consequences of low iron in pregnancy?

A

Anaemia. Increased risk of low birth weight and premature delivery. Increased maternal tiredness, reduced milk production and depression

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13
Q

Within the midiwifery scope of practice, what does preconception advice cover?

A

Suggesting taking folic acid and maternal screening. Also may include referring to obstetrician for genetic counselling

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14
Q

When are bloods taken in pregnancy?

A

Booking visit (before 12 weeks)
26 - 28 weeks
36 weeks

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15
Q

What is tested for in the booking bloods?

A
  • Ferritin
  • FBC
  • Antibody screen (Rh factor, white and red blood tells, hb level)
  • STI’s (HIV, syphilis)
  • Rubella antibodies
  • HbA1c diabetes
  • Blood group
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16
Q

What is tested for in the 26 - 28 week bloods?

A
  • Ferritin
  • Antibody screen
  • FBC
  • Polycose
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17
Q

What is tested for in the 36 week bloods?

A
  • Ferritin

- Antibody screen

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18
Q

What is the healthy weight gainer singleton pregnancy with BMI <18.5

A

12.5 - 18kg

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19
Q

What is the healthy weight gainer singleton pregnancy with BMI 18.5 - 24. 9?

A

11.5 - 16kg

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20
Q

What is the healthy weight gainer singleton pregnancy with BMI 25.0 - 29.9

A

7kg - 11.5kg

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21
Q

What is the healthy weight gainer singleton pregnancy with BMI >30

A

5 - 9 kg

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22
Q

What are risk factors for the mama with increased BMI?

A
  • Gestational diabetes
  • Failed IOL
  • C-section
  • Delayed lactogenesis
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23
Q

What are risk factors for the baby with a mama with an increased BMI?

A
  • LGA

- Birth injury

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24
Q

What are the three types of diabetes testing?

A
  • HB1AC at booking (average BSL over last 6 - 8 weeks)
  • GCT - Glucose Challenge Test (1 hour)
  • GTT - Glucose Tolerance Test (diagnostic - 2 hour test - fasting)
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25
Q

Low BMI and GWG risks

A
  • Miscarriage
  • SGA
  • Premature birth
26
Q

How is iron deficiency anaemia diagnosed?

A

Hb <100g/l and Fe <15umol/L

27
Q

What is the haemoglobin normal range?

A

100 - 145g/L

28
Q

What is the normal serum ferritin normal range?

A

30 - 170 umol/L

29
Q

What treatment would you give for hb>100 and fe >30

A

No treatment

30
Q

What treatment would you give for hb <100 and fe >30

A

Diagnosis with anaemia, could commence low dose iron therapy

31
Q

What treatment would you give for hb <100 and fe <30

A

Discuss dietary options and consider low dose iron supplementation

32
Q

What treatment would you give hb >100 and <15

A

Low dose iron supplementation = 1x ferrotab (ferrous fumarate 200mg tab) and retest in 4 weeks = if haven’t improved = high dose iron supplementation

33
Q

What treatment would you give for hb <100 and fe <15

A

Diagnosis with iron deficiency anaemia. Start high dose iron supplementation = 2x ferrotab or 1 ferrogradument (325mg controlled release). Give advice on how to avoid constipation. Refer for IV iron therapy if hb <70g/L or can’t take tablets

34
Q

What sources of food can you get folic acid from?

A

Leafy green vegetables (spinach, silver beet, broccoli, cabbage, whole grains)

35
Q

What sources of food can you get iodine from?

A

Fish
Seafood
Seaweed

36
Q

What sources of food can you get iron from?

A

Red meat
Fish/Seafood
Eggs
Wholegrain or fortified breads
Green leafy vegetables (spinach)
Dried fruits
Nuts
Seeds
Marmite/Vegemite

37
Q

What sources can you get vitamin d from?

A

90% from sunlight
coffee, liver,
oily fish (salmon)
Fortified dairy products (butter, milk ,eggs)

38
Q

What food can you get calcium from?

A

Milk
Cheese
Butter
Yoghurt
Dried apricots
Tinned fish with bones (salon, sardines)

39
Q

What is vitamin D important for in pregnancy?

A

For general fetal growth and development
Muscle function, formation of the fetal skeleton
Bone health and aids in calcium absorption

40
Q

What is calcium important for in pregnancy

A

For healthy bones and teeth
Is often used to regulate blood pressure and can be preventative in hypertension disorders (used in combination with LDA)

41
Q

What are risk factors for having low folic acid?

A
  • Relevant family history
  • Obese
  • Diabetic
  • Anticonvulsant therapy
42
Q

What is the recommended dose of folic acid for those at high risk of being deficient?

A

5mg PO daily

43
Q

What aids iron absorption?

A

Vitamin C

44
Q

Once commencing iron supplementation how long should you wait to recheck levels?

A

4 weeks

45
Q

Who is at high risk of being vitamin D deficient?

A

Dark skin
Covered skin
Higher BMI

46
Q

What is the recommended dose of vitamin D?

A

10 - 15mcg PO daily
Should also be taking calcium

47
Q

Who is at risk of needing calcium supplementation?

A

Preeclampsia
Hypertension
Preterm birth
Low birth weight

48
Q

What is the recommended dose of calcium?

A

1g daily (2x 500mg calcitab)

49
Q

When should pregnant mama be taking calcium?

A

Use between 12 -16 weeks up until 36 weeks gestation

50
Q

What is required for mss1 screening?

A

Blood test and nuchal translucency scan in the first trimester

51
Q

What is the recommended timeframe for MSS1 screening - blood test and scan

A

Blood test: 9 - 13 + 6 weeks
NT scan: 11 - 13 + 6

52
Q

What is required for MSS2 screening?

A

NT scan

53
Q

When can MSS2 screening be completed?

A

Between 14 and 20 weeks

54
Q

When can NIPT be completed?

A

A blood test after 10 weeks gestation

55
Q

When should aspirin be commenced if needed?

A

Between 12 - 16 weeks and stopped at 36 weeks

56
Q

What category referral is required for hb <90 and not responding to treatment?

A

Consultation

57
Q

What is haematocrit (HCT)

A

Percentage of RBCS relative to the portion of plasma

58
Q

What is mean cell volume?

A

Size of RBC’s

59
Q

What is mean cell haemoglobin?

A

Average amount of hb in RBCs

60
Q

Who should have high dose folic acid supplementation?

A
  • Previous history of NTD
  • Family history of NTD
  • High BMI >30
  • Coelic disease
  • Anticonvulsants
61
Q

Morag’s haemoglobin is 70g/L and Ferriting 6ug/L at 36 weeks of gestation. Your plan would be to:

A

Refer Morag for a consultation so she can be prescribed IV Iron therapy (Ferinject).

Midwifery (36 decks)

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