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Repro AM > Antenatal care and screening > Flashcards

Antenatal care and screening Flashcards

1
Q

What problems are associated with pregnancy?

A

Morning sickness
UTI
Anaemia
Acid reflux

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2
Q

Who is morning sickness seen in?

A

80-85% women

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3
Q

When is morning sickness worse?

A

When human chorionic gonadotrophin i higher i.e. twins or molar pregnancies

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4
Q

What can morning sickness progress to?

A

hyperemesis gravidarum

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5
Q

When is morning sickness usually better by?

A

16 weeks

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6
Q

What causes UTIs in pregnancy?

A

Increase in urinary staiss

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7
Q

What renal conditions are more common during pregnancy?

A

UTI

Pyelonephritis

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8
Q

What is pyelonephritis in pregnancy associated with?

A

Hydronephrosis in 3rd trimester

Preterm labour

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9
Q

When is anaemia treated in pregnancy?

A

If Hb is <110 or less than 100 on routine testing at 28 weeks

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10
Q

What counselling is done for all women hoping to get pregnant?

A

General health- improve diet, optimise BMI, reduce alcohol consumption
Smoking cessation
Folic acid- 3 months pre pregnancy
Confirm immunity to rubella

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11
Q

Who is a pre pregnancy screening vital in?

A

Women with previous health or pregnancy problems

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12
Q

What is essential to do pre pregnancy in women with previous health problems?

A 
Optimise maternal health
Psych
Stop/change any unsuitable drugs
Advice regarding complications associated with maternal medical problems
Occasionally advise against
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13
Q

What is advised in women with a previous section?

A

1 section for non recurring cause= can trial labour

2 sections or recurring cause= opt to section

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14
Q

How is risk of recurrence of DVT or pre-eclampsia reduced?

A

Low dose aspirin
Thromboprophylaxis
Monitor

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15
Q

What is done for women with foetal problems in previous pregnancy?

A

Counsel regarding risk of recurrence

Reduce risk of recurrence-treat infection, high dose folic acid, low dose aspirin

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16
Q

What are the direct causes of maternal death?

A 
Sepsos
Thrombosis
Haemorrhage
Pre-eclampsia
Amniotic fluid embolism
Anaesthesia
Other
17
Q

What are the indirect causes of maternal death?

A 
Cardiac disease
Neuro
Psych
Sepsis
Other
18
Q

What is done on abdominal palpation in an antenatal exam

A 
Fundal height
Size of baby
Liquid volume
Foetal presentation
Foetal heart rate
19
Q

What antenatal screening is done?

A 
Hep B
Syphilis
HIV
MSSU for UTI
Iron deficiency anaemia
Isoimmunisation for Rhesus disease, anti C and anti Kell
US
20
Q

Why is rhesus disease screened for?

A

When a rhesus - woman has a rhesus + baby, she will develop antibodies agains the foetal red blood cells during labour
If she has another rhesus + baby, this will kill it in utero

21
Q

What is done on a first US and when?

A 
10-14 weeks
Ensure pregnancy viable
Multiple pregnancy
Identify anomalies incompatible with life
Offer Down's screening
22
Q

What is the risk of having a baby with Down’s at age 20 and at age 45?

A

1 in 1667

1 in 30

23
Q

What are the Down’s screening tests?

A

1st trimester screening
CVS
Amnioscentesis

24
Q

When is the first trimester screening for Down’s carried out?

A

10-14 weeks

25
Q

What is assessed on the 1st Down’s screening test?

A

Maternal risk factors
serum BTa human chorionic gonadotrophin
Pregnancy associated plasma protein a PAPPA
Foetal nuchal translucency

26
Q

When is further testing for down’s offered?

A

if risk >1 in 150

27
Q

When is CVS done and what is the miscarriage rate?

A

10-14 weeks

1-2%

28
Q

Whenis amniocentesi done and what is the miscarriage rate?

A

15 weeks on

1%

29
Q

When is a 2nd US done?

A

18-20 weeks

30
Q

What is done on a 2nd US?

A

Normal growth and development

Major physical abnormalities

31
Q

When is screening test for neural tube defect done?

A

FH of neural tube defect

32
Q

What is used to reduce risk of neural tube defect?

A

5mg folic acid

33
Q

What are the screenings for neural tube defect?

A

1st US- ancephaly and sometimes spina bifida
2nd trimester biochemistry screening- maternal serum tested for alpha fetoprotein
anomaly scan will detect >90% neural tube defects

34
Q

What is seen as “high risk” biochemistry for neural tube defect?

A

> 2 materna serum alpha fetoprotein

Repro AM (27 decks)

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