Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro > Antenatal Care > Flashcards

Antenatal Care Flashcards

1
Q

How many women get morning sickness?

A

80-85%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is morning sickness worse and what do we call the extreme form?

A

Worse when Human Chorionic Gonadotrophin is high e.g. in twins or molar pregnancies

Can progress to Hyperemesis Gravidarum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why does pregnancy increase Cardiac Output? and by how much does it increase?

A

Normal pregnancy raises CO from 30-50% due to HR rising from 70-90BPM
This is to maintain a high blood flow to the foetus

This can present as palpitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does blood pressure change physiologically during pregnancy; why?

A

Drops during the 2nd trimester

A mixture of effects:

  • Uteroplacental circulation expands
  • SVR drops
  • Blood viscosity drops
  • Angiotensin sensitivity drops
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When does BP return to normal during pregnancy?

A

Third trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why does urine output increase in pregnancy?

A

Renal plasma flow(25-50%) and GFR increase(50%)

Serum Urea; Creatinine also decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why are pregnant women more at risk of UTIs?

A

Urinary stasis increases, in fact, hydronephrosis is even physiological come the 3rd trimester.
Making UTIs and pyelonephritis very common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the major danger of a UTI to a pregnant woman?

A

Preterm labour.

So very important to treat them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why are pregnant women at risk of anaemia?

A

Because plasma volume increases by 50% but RBC mass only goes up by 25%

So a lower Haemoglobin is normal in pregnancy but you still want to ensure it doesn’t drop too low.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does pregnancy affect blood cell counts?

A

WBC count increases slightly

Platelet count falls (due to rise in blood volume not loss of platelets)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does pregnancy affect the lungs?

A

Progesterone acts to reduce CO2 by:

  • Increasing tidal volume
  • Increased Resp rate
  • Increases plasma pH

This increases O2 consumption by 20% but plasma PO2 is unchanged

You also get hyperaemia of the resp mucous membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does pregnancy affect the GI system?

A

GI motility is reduced, specifically:

Oesophageal peristalsis reduced

Gastric emptyin slows

Cardiac sphincter relaxes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What hormones cause GI motility to be decreased in pregnancy?

A
  • Increased Progesterone

- Decreased Motilin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some normal symptoms of physiological changes in pregnancy? (i.e. symptoms mothers get in normal pregnancies?)

A

Nose bleeds from resp mucous membrane hyperaemia

SOB from progesterone increases resp rate etc

Constipation; GORD from reduction in GI motility; pressure of foetus

Palpitations from increased HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Whats included in pre-pregnancy counselling?

A

Diet
Optimise BMI
Alcohol reduction
Smoking cessation

Folic Acid supplements
Rubella immunisation (if needed)

Optimise maternal health, mental health and medications
Advise on maternal complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When would you advise against pregnancy in pre-pregnancy counselling?

A

In certain conditions like Diabetes or Epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Many maternal/fetal issues may recur in the next pregnancy, give 3 examples of these that are important in pre-pregnancy counselling?

A

Maternal?
Caesarean section
DVT
Pre-eclampsia

Fetal?
Pre-term delivery
Intrauterine growth restriction
Fetal Abnormality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Whan can we do at pre-regnancy counselling to reduce the risk of previous problems recurring?

A

Thromboprophylaxis if h/o DVT aka low dose aspirin

Treat any infections
High dose folic acid to reduce abnormalities

19
Q

Whats involved in a routine antenatal exam?

A
  • Feeling well?
  • Feeling fetal movements (>20wks)
  • BP
  • Urinalysis: UTI?
  • Abdominal palapation
  • Listen to fetal heart
20
Q

Abdominal palpation is an important part of an antenatal exam, what can it tell us?

A
  • Fetal presentation
  • Sympheseal Fundal height (SFH)
  • Estimate baby size
  • Estimate Liqour volume
21
Q

How do we determine which mothers to do antenatal screening on?

A

We dont.

We offer it to everyone but its not compulsory

22
Q

What is looked for on an Antenatal screen?

A
  • Hepatitis B
  • Syphilis
  • HIV
  • MSSU for UTI
  • Rubella
  • Fe-deficient Anaemia
  • Isoimmunisation e.g. Rhesus disease

US scans for physical abnormalities
Down syndrome
Neural Tube defects

23
Q

How do we treat if a basic antenatal screen throws up an infection in the mother?

A

Hep B give passive and active immunisation to baby

Syphilis give penicillin

HIV give maternal treatment to prevent vertical transmission

24
Q

How many US scans are women offered?

A

One in their first and 1 in their 2nd trimester

25
Q

What is shown on a 1st visit US?

A

Is the pregnancy viable?
Single or multiple pregnancy?
Abnormalities incompatible with life

26
Q

When is down syndrome testing offered?

A

10-14 weeks gestation

27
Q

How do we initially test for Down’s Syndrome?

A
  • Serum B-human Chorionic Gonadotrophin (Beta-hCG)
  • Pregnancy associated plasma protein A (PAPP-A)
  • Fetal Nuchal Translucency (NT)
28
Q

How does fetal nuchal translucency help identify Down’s Syndrome?

A

Based on the size of the nuchal translucency, it increases with age so:
Risk of Down’s is related to size of NT relative to the maternal age.

29
Q

From initial tests how do we decide if a fetus requires further testing for Down’s?

A

Initial screening give a 1 in something risk of Down’s.

Further invasive tests are offered if risk is estimated at > 1in150

30
Q

What further tests are available for Down’s?

A

Chorionic Villus sampling (CVS) (10-14wks)
Amniocentesis (>15wks)
Non-invasive Prenatal Testing

These all have a small but significant risk of miscarriage (<1 -> 2%)

31
Q

How does Non-invasive prenatal testing for Down’s Work?

A

Its done after initial testing if high risk

Take maternal blood and detect fetal cell free DNA then look for Trisomies.

However its not on NHS (yet, it will be soon)

32
Q

How do we screen for neural tube defects?

A

Part of the first trimester US, should pick up anencephaly; sometimes Spina bifida

Possibly 2nd trimester biochemical screening

2nd trimester US

33
Q

Why & how would we do 2nd trimester biochemical screening?

A

If we couldn’t get a NT measurement from the US

Take maternal serum alpha fetoprotein. >2MoM is high risk

34
Q

What does and doesnt show on a 2nd trimester US?

A

Picks up >90% of major structural abnormalities e.g. exomphalos and cleft palate

But misses a number of chromosomal abnormalities such as Downs, T13 or T18

35
Q

When does morning sickness improve?

A

after 16 weeks

36
Q

How much blood flow does the uterus need at term?

A

1L/min

37
Q

Why does bladder capacity reduce in 3rd trimester?

A

due to uterus expansion- presses on bladder

38
Q

what happens to iron requirements during pregnancy?

A

They increase by 1g.

If they are controlled then it is easier to deal with blood loss at pregnancy.

39
Q

What is NT and when is it sampled?

A

It is a collection of fluid which presents behind the babies head.
Nuchal translucency test are taken when Crown Rump Lengths of 45-84mm/ 11-14 weeks

40
Q

When is Second trimester screening carried out?

A

20 weeks

41
Q

Risks with epilepsy in pregnancy?

A

Sodium Valproate treatment can cross placenta and is associated with higher levels of spina bifida

42
Q

Risk with thyroid problems in pregnancy

A

Hypothyroidism
o Women taking thyroxine
o Demand may increase during pregnancy
o Normal levels are required for foetal brain development

Hyperthryoidism
o Thyroid stimulating antibodies can cross the placenta so neonate will need to be checked as well
o Graves disease

43
Q

Risks with diabetes in pregnancy

A

TRY to control before pregnancy
- high blood glucose is associated with congenital abnormalities

  • Cannot use oral hypoglycemic medicines - need to switch to insulin
  • Higher risks of macrosomia, pre-eclampsia, stillbirth
44
Q

Risks with renal disease in pregnancy

A

More liklely to develop pre-eclampsia- difficult to diagnose if they already have proteinuria and pre-existing hypertension

Repro (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions