Antenatal Care Flashcards
Give 6 maternal causes of high risk pregnancy?
extremes of age Chronic illness Infections Drugs Poor past obstetric history Obstetric complications
What is the age at which pregnant women are regarded as ‘older mothers’?
35 y/o
Why may an epileptic woman have a high risk pregnancy?
The woman may be on phenytoin which affects vitamin K metabolism which can have detrimental affects on the baby.
Guve 6 examples of fetal causes of a high risk pregnancy
Multiple pregnancy Twin to twin transfusion syndrome Congenital Abnormality Chromosomal abnormalities Intrauterine growth resection Hydrops fetalis
What is twin to twin transfusion syndrome?
Where you have twins one of which is the donor and one of which is the recipient. One twin is giving blood to the other twin. The recipient becomes swollen and polycythemic, the donor becomes small and anaemic
What is Gastroschisia?
A congenital abnormality in the anterior abdominal wall where the abdominal contents freely protrude.
What is hydrops fetalis?
Where there is excess body water causing oedema of the fetus.
Give three causes of hydrops fetalis
Anaemia
Cardiac disease
Noonans Syndrome
What is Noonan’s Syndrome?
An autosomal dominant abnormality which leads to pulmonary stenosis, short stature, pectus excavatum, webbed neck and flat nose
What blood typing is performed on pregnant woman?
Blood group and antibodies for Rhesus.
If a woman is found to be Rh -ve in pregnancy then what will be done?
She will be given anti D at 28 and 34 wks to prevent an antibody attack if the baby is Rh+ve
What infections are tested for in pregancy?
Hep B Hep C Rubella Syphilis HIV
What blood test is carried out in pregnancy to screen for neural tube defects?
AFP which is high
Reduced risk with folic acid
What is the triple test for Trisomy 21?
AFP
B-HCG
Estriol
to test for down’s
In the UK what pregnancy screening will be offered to ethnic groups?
Hb for Thalassaemia or sickle cell
What is the test which is performed at 10-14 weeks gestation to screen for down’s? What does the test involve?
Nuchal Translucency
US of nuchal fold at back of neck, thickening is indicative of down’s.
How will the triple test look if the foetus has down’s?
Low AFP
Low Estriol
High B-HCG
At what risk of down’s will the woman be offered amniocentesis?
1:250
Why may AFP be high in pregnancy when there is not a problem?
Wrong dates
Multiple pregnancy
Bleeding in early pregnancy
If the AFP is high in pregnancy then what problems may this suggest?
Neural Tube Defects
Cardiac abnormalities
Gastroschisis
What may a low AFP in pregnancy suggest?
Down’s Syndrome
Name 4 Diagnostic tests which can be performed antenatally
20 wk USS
Chorionic Villus Sampling
Amniocentesis
Fetal Blood Sampling
What is the main issue that is of concern in preterm babies?
Respiratory Distress Syndrome
Why do preterm develop Respiratory Distress Syndrome? and how is this corrected?
Their lungs are underdeveloped and so do not produce surfactant. Steroids, either at birth or when preterm labour starts.
What are Tocolytic Drugs? Give an example of a Tocolytic drug and why it is used?
Drugs which delay birth.
Salbutamol is an example and they are given so they steroids can be administered which may decrease respiratory distress syndrome.
What conditions is diabetes during pregnancy associated with which affect the mother ?
Polyhydramnios,
Pre-eclampsia,
Increased miscarriage
What is Polyhydramnios and what disease in pregnancy is it commonly associated with?
Polyhydramnios is too much amniotic fluid surrounding the feotus. It is associated with diabetes.
What problems are associated with Diabetes which affect the fetus/neonate?
Intrauterine Growth restriction Macosomia Hypoglycaemia Respiratory Distress Syndrome Hypertrophic cardiomyopathy polycythaemia rubra vera
What is the differnce in risk between a mother with insulin dependant diabetes and a mother with gestational diabetes?
Gestational diabetes usually resolves after the birth of the infant. There is also a smaller chance of there being congenital abnormalities of the fetus
How can Diabetes in pregnancy cause both macrosomia and intrauterine growth restriction?
IUGR is associated with microvascular disease in the mother and macrosomia is increasd in all pregnant diabetics.
Why do neonates get hypoglycaemia if their mothers are diabetic?
Because they are getting a high supply of sugar in the womb and so to maintain homeostasis produce higher amounts of insulin. When this glucose rish blood is no longer there, the insulin levels can remain high and so the neonate can be hypoglycaemic
How does hyperthyroidism affect the fetus in pregnant women?
The fetal thyroid can become overstimulated and so the newborn will have symptoms of hyper thyroid including trembling, diarrhoea and tachycardia
What condition in preganncy are woman with SLE more likely to develop?
Antiphospholipid syndrome
What are the risks associated with antiphospholipid syndrome?
IUGR, miscarriage, preterm delivery and placental abruption
What antibodies will be present in antiphispholipid syndrome when there is a heart block in the neonate?
anti-Ro
anti-la
