Antenatal Care Flashcards
Advanced maternal age risks
Chromosomal abnormalities
HPT
DM
Vascular disease
Maternal mortality increased
Tx( amniocentesis between 16-18weeks)
Genetic counselling offered to all before 20weeks
Regular BP monitoring
Screen for DM
Refer to hospital
Risks of Grand parity (P5 or more)
Rupture of uterus
PPH
HPT, DM, Chromosomal abnormalities
Ca Cervix
Anaemia
Unstable lie
Max: Do Pap smear before 30weeks
Give Iron and folate
Refer to hospital at 36weeks, anytime if HB<8
Criteria for referral for abnormal SFH chart
When ONE measurement is below 10th centile
When THREE SUCCESSIVE measurements remain the same
When a measurement less than that recorded TWO Visits before
Mention four clinical features on abdominal palpation that might be associated with a diagnosis of IUGR
■Hard fetal head
■Height of fundus less than expected
■Baby small for gestational age
■Decreased liquor
■Uterine irritability
What patterns on the graph suggests IUGR
■ Two successive measurements < 10th centile
■ Three separate measurements < 10th centile
■ Three successive measurements ‘plateau’ without necessarily crossing the 10th centile
■ A measurement that is less than that recorded 2 visits previously without necessarily crossing the 10th centile
Epidural analgesia contraindications
Patient refusal
Coagulopathy or thrombocytopenia e.g. HELLP syndrome
Active or uncontrolled haemorrhage e.g. abruption or placenta praevia
Local skin sepsis in lumbo-sacral region
Known allergy to local anaesthetic drugs
Inadequate resuscitation equipmen
Relative
Advanced aortic or mitral stenosis•Thrombocytopenia•Active neurological disorders or spinal abnormalities•Eclampsi
Complications of epidural analgesia
Hypotension
Nausea and vomiting
Sedation
Shivering
Modest increase in body temperature
Motor weaknes
