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Reproduction > Antenatal care > Flashcards

Antenatal care Flashcards

1
Q

When does the booking visit take place?

A

8 - 12 weeks

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2
Q

When does the dating USS take place?

A

11 - 12 weeks

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3
Q

When does the anomaly scan take place?

A

20 weeks

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4
Q

When do you get monthly visits in pregnancy?

A

Up to 28 weeks

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5
Q

When do you get fortnightly visits in antenatal care?

A

28 - 36 weels

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6
Q

When do you get weekly visits in antenatal care?

A

37 weeks until delivery

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7
Q

What needs to be done at every antenatal visit?

A 
BP
Urinalysis
FSH
Fetal heart/kicks
Any problems refer to consultant
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8
Q

A women has hypertension present as 12 weeks gestation. What is the diagnosis?

A

Essential hypertension (not pregnancy related)

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9
Q

When does gestational hypertension occur?

A

After 20 weels

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10
Q

When does pre eclampsia occur?

A

After 20 weeks

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11
Q

What is HELLP syndrome?

A

Haemolysis
Elevated Liver Enzymes
Low platelets

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12
Q

What drug is given to women who are thought to be at risk of pre eclampsia?

A

Aspirin

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13
Q

What BP are you aiming for in pregnancy?

A

Less that 150/80

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14
Q

What BP are you aiming for in pregnancy if there is target organ damage?

A

Less than 140/90

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15
Q

If a women has pre eclampsia when should you aim to deliver the baby?

A

37 weeks

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16
Q

If the mother is diabetes is the baby more likely to be hypo or hyperglycaemia at birth?

A

Hypoglycaemia

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17
Q

How often should diabetic women have retinal screening in pregnancy?

A

Every trimester

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18
Q

What should the HBA1C be during pregnancy?

A

Less than 6%

19
Q

Above what predicted weight of the fetus should a caesarean section be advised?

A

4000g

20
Q

Why is there an increased risk of VTE in pregnancy?

A

Stasis secondary to venous compression by the pregnant uterus
Hypercoagulability due to oestrogen

21
Q

Levels of which blood clotting factors increase in pregnancy?

A

VII, VIII, X and Fibrinogen

22
Q

Levels of which blood clotting factors decrease in pregnancy?

A

XI and antithrombin 3

23
Q

Which test for VTE should you not do in pregnancy?

A

D Dimer

24
Q

How should you investigate VTE in pregnancy?

A

Duplex US

25
Q

What is the treatment of VTE in pregnancy?

A

Heparin

26
Q

Does heparin cross the placenta?

A

No

27
Q

What investigations would you do if you suspected a PE?

A 
ABG
CXR
ECG
Duplex US of the lower limbs
VQ scan
CTPA
28
Q

What is the treatment for PE?

A

Heparin

29
Q

When should warfarin definately be avoided in pregnancy?

A

Week 6 - 12

30
Q

Is warfarin safe during breastfeeding?

A

Yes

31
Q

When does hyperthyroid get worse during pregnancy and why?

A

First trimester due to HCG

32
Q

How often should you do thyroid function tests in pregnancy?

A

Every trimester

33
Q

Describe the respiratory changes seen in pregnancy?

A
  • Increase O2 demand
  • Tidal volume INCREASE
  • INCREASE respiratory rate
  • INCREASED inspiratory capacity
  • DECREASED residual volume
  • DECREASED expiratory reserve
  • DECREASE in functional residual capacity
  • FEV1 and PEFR UNCHANGED
34
Q

Why is there a decrease in functional residual capacity during pregnancy?

A

Diaphragmatic elevation

- Increase in tranvsverse thoracic diameter and subcostal angle

35
Q

How is asthma treated in pregnancy?

A

Same as not in pregnancy!

36
Q

How much folic acid should epileptic women take in pregnancy?

A

5mg

37
Q

What vitamin should pregnancy women take from 36 weeks in they are taking liver enzyme inducing anticonvulsants?

A

Vitamin K

38
Q

Why do epileptic women have an increased risk of seizure in the first trimester?

A

Hyperemesis and haemodiluation cause less available anti convulsant

39
Q

What anomoly scans should pregnant epileptic women get?

A

Detailed fetal scan at 18 - 20 weeks

Fetal cardiac scan at 22 weeks

40
Q

You suspect HELLP syndrome is a women who is 32 weeks pregnant. What tests would you perform?

A 
FBC
Coagulation screen
LFTs
U&E
Lactate dehydrogenase
41
Q

A women presents with abdominal pain and confusion is the 35th week of pregnancy. Her lactate dehydrogenase is elevated.

A

HELLP syndrome

42
Q

What is the lactate dehydrogenase a marker of in HELLP syndrome?

A

Haemolysis

43
Q

How do you treat HELLP syndrome?

A

Delivery of the baby
DIC is treated with fresh frozen plasma
IV fluids
(Magnesium sulphate may help stop seizures)

Reproduction (40 decks)

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