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Reproduction and the growing child > Antenatal care > Flashcards

Antenatal care Flashcards

1
Q

Childbirth has become increasingly …

A

Medicalised

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2
Q

Birth rate is

A

Dropping

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3
Q

Average age of mother in 2017 =

A

30.5

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4
Q

Which group of women chose to give birth at home?

A

Older women

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5
Q

what study compared the safety of birth in 4 different settings?

A

Birthplace cohort study (2011)

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6
Q

Areas looked at in the birthplace cohort study:

A
  1. Home
  2. Freestanding midwifery units
  3. Alongside midwifery units
  4. Obstetric units
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7
Q

Main findings of birthplace cohort study:

A
  • For low risk women the incidence of adverse perinatal outcomes was low
  • No difference in outcomes for freestanding, alongside and obstetrics units
  • For nulliparous, outcomes in obstetric units is associated with better outcomes
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8
Q

Aims of antenatal care:

A
  • Continuity of care/personal relationship
  • Monitor progress of pregnancy
  • Monitor fetal and mother health
  • Refer deviations from the norm
  • Promote choice
  • Public health promotion
  • Prepare for birth and parenthood
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9
Q

What can be used to inform antenatal care?

A 
MBRRACE-UK
NICE
Local policy
Midwifery 2020
National maternity review
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10
Q

MBRRACE-UK

A

Mother and baby risk reduction using audits and confidential enquiries

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11
Q

Name of national maternity review report

A

‘Better births’

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12
Q

‘Better birth’ themes

A

Personalised care
Continuity of care
Safer care
Better postnatal and perinatal mental health

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13
Q

Booking appointments tends to last for:

A

1-1.5 hrs

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14
Q

NICE recommends booking appointment to be before when?

A

10 weeks

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15
Q

What happens in booking interview:

A
  • Build relationship
  • Identify concerns and discuss
  • Baseline measurements
  • Hx
  • Public health promo
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16
Q

Information that should be gathered in the Hx at booking:

A
  • Demographics
  • Present pregnancy and menstrual Hx
  • Previous pregnancies
  • Medical Hx
  • Surgical Hx
  • Lifestyle and social Hx
  • FHx (e.g. pre-eclampsia)
  • baseline obs
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17
Q

How many antenatal visits would a parous women get?

A

7

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18
Q

How many antenatal visits would nulliparous women get?

A

10

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19
Q

Added visits to an NP women occur at:

A

25 weeks
31 weeks
40 weeks

20
Q

Physical exam:

A 
Weight
BP
Urinalysis
Oedema
Varicosities
Nausea and vomiting
Bladder and bowels
Blood tests
21
Q

What is checked for in blood tests?

A 
ABO blood types
Rhesus factor
antibodies
Full blood count
Syphillis, HepB, HIV,
Rubella immune status
Haemoglobinopathies
22
Q

What is the abdo exam used to assess?

A 
Fetal growth and size
Wellbeing
Presentation
Positioning
Engagement
23
Q

Abdominal palpation for presentation should be after when?

A

36 weeks

24
Q

How to prep to assess fundal height:

A

Empty bladder

25
Q

Fundal height is measured from

A

Fundus of uterus to top of symphisis pubis

26
Q

Weeks gestation when fundus is at umbilicus:

A

24 weeks

27
Q

Position of baby can be:

A

transverse
Logitudinal
Oblique

28
Q

Ideal position:

A

Logitudinal

29
Q

Ideal presentaiton:

A

Cephalic

30
Q

Presentaiton can be:

A

Cephalic
Breach
Oblique

31
Q

Engagement occur when

A

The widest diameter of detal head has entered into the pelvis

32
Q

Engagement of head is measured in

A

fifths

33
Q

Head is ‘engaged’ at what level

A

2-3/5

34
Q

Engagement with 1st baby usually occurs around

A

36 weeks

35
Q

Enagagement with parous women can occur

A

Just before labour

36
Q

When does the combined screening test occur?

A

10-12 weeks

37
Q

When does fetal abnormality scan occur?

A

18-20 weeks

38
Q

Risk factors to look for that can effect pregnancy outcome:

A
  • Chronic or acute disease
  • Proteinuria
  • Increase BP
  • OEdema
  • Uterus large/small for gestational age
  • Mal presentation
  • Bleeding
  • Infection
39
Q

Pre-eclampsia is due to problems with:

A

Spiral arteries

40
Q

Signs of pre-eclampsia:

A

Proteinuria

Hypertension

41
Q

HELLP syndrome:

A

Hemolysis
elevated liver enzymes
low platlets

42
Q

Pre-eclampsia risk factors:

A
  • FHx
  • Hypertension
  • Diabetes
  • Obesity
  • > 35 yrs
  • 1st pregnancy
  • multiple gestations
43
Q

What causes seizures in ecclampsia?

A

Cerebral oedema

44
Q

Miscarriage occurs before

A

24 weeks

45
Q

Stillbirth =

A

Born after 24 weeks, no signs of life

Reproduction and the growing child (15 decks)

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