Antenatal advise Flashcards
What nutritional supplements should be given and when? [2]
Folic acid - 400mcg
- before conception until 12 weeks
Vitamin D
- daily supplement containing 10micrograms of vitamin
What risk does smoking have on a newborn? [2]
low birthweight and preterm birth should be discussed
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Which anti-smoking medications should not be offered to pregnant or breast feeding women? [2]
neither varenicline nor bupropion should be offered to pregnant or breastfeeding women
Which foods should be avoided and why during pregnancy? [2]
listeriosis - caused by:
- unpasteurised milk
- ripened soft cheeses
- pate or undercooked meat
salmonella:
- avoid raw or partially cooked eggs and meat, especially poultry
What advise would you give about air travel during pregnancy? [3]
- women > 37 weeks with singleton pregnancy and no additional risk factors should avoid air travel
- women with uncomplicated, multiple pregnancies should avoid travel by air once >32 weeks
- associated with increased risk of venous thromboembolism
- wearing correctly fitted compression stockings is effective at reducing the risk
Which drugs can be given for N&V in pregnancy? [2]
antihistamines should be used first-line (BNF suggests promethazine as first-line)
natural remedies - ginger and acupuncture on the ‘p6’ point (by the wrist) are recommended by NICE
Why are NSAIDs generally not prescribed in pregnancy? [2]
Prostaglandins are important in maintaining the ductus arteriosus in the fetus and neonate
Prostaglandins also soften the cervix and stimulate uterine contractions at the time of delivery
Therefore
- They are particularly avoided in the third trimester, as they can cause premature closure of the ductus arteriosus in the fetus.
- They can also delay labour.
What affect can beta blockers have if given during pregnancy? [3]
Which beta-blockers are used if neeed? [1]
Beta-blockers can cause:
* Fetal growth restriction
* Hypoglycaemia in the neonate
* Bradycardia in the neonate
Labetalol is the most frequently used beta-blocker in pregnancy, and is first-line for high blood pressure caused by pre-eclampsia.
What is the affect of of ACEin or ARBs in pregnancy? [4]
- Oligohydramnios (reduced amniotic fluid)
- The other notably effect is hypocalvaria, which is an incomplete formation of the skull bones.
- Renal failure in the neonate
- Hypotension in the neonate
- Miscarriage or fetal death
What affect can opiates cause if given during pregnancy? [1]
The use of opiates during pregnancy can cause withdrawal symptoms in the neonate after birth. This is called neonatal abstinence syndrome (NAS).
NAS presents between 3 – 72 hours after birth with irritability, tachypnoea (fast breathing), high temperatures and poor feeding.
Warfarin is considered teratogenic in pregnancy, therefore it is avoided in pregnant women. Warfarin can cause [3]
- Fetal loss
- Congenital malformations, particularly craniofacial problems
- Bleeding during pregnancy, postpartum haemorrhage, fetal haemorrhage and intracranial bleeding
The use of sodium valproate in pregnancy causes [] and []
The use of sodium valproate in pregnancy causes neural tube defects and developmental delay.
Lithium is particularly avoided in the [] trimester, as this is linked with congenital [] abnormalities.
- In particular, it is associated with [] anomaly
Lithium is particularly avoided in the first trimester, as this is linked with congenital cardiac abnormalities
- In particular, it is associated with Ebstein’s anomaly
Lithium is associated with Ebstei’s anomaly.
Describe what this is [1]
where the tricuspid valve is set lower on the right side of the heart (towards the apex), causing a bigger right atrium and a smaller right ventricle.
Which antidepressants are most commonly used in pregnancy? [1]
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used antidepressants in pregnancy.
