Antenatal Care and Screening Flashcards
When can morning sickness get worse?
When HCG levels are higher e.g twins or molar pregnancy
What can morning sickness progress to@
Hyperemesis Gravidarum
How does cardiac output change in pregnancy?
It increases by 30-50%
HR increases from 70-90bpm
Palpitations are commin
How does blood pressured change in the second trimester?
It drops due to expansion of uteroplacental circulation.
There is a reduction in blood viscosity, sensitivity to angiotensin and systemic vascular resistance
What happens to urine output during pregnancy?
Renal plasma flow increases, GFR increases and serum urea/creatinine decrease = INCREASED URINE OUTPUT
Why are UTIs more common in pregnancy>?
Increase in urinary stasis
Hydronephrosis is also physiological in third trimester = increased chance of pyelonephritis
Why should UTIs be treated immediately in pregnancy?
Pregnant women more prone to sepsis
Also can lead to preterm labour
Why can anaemia occur in pregnancy?
50% increase in Plasma Vol, RBC mass increase by 25% = dilution of haemoglobin
How is anaemia treated in pregnancy?
Liquid iron or IV iron
Why is it important to optimise haemoglobin before giving birth?
Birthing process can involve a lot of blood loss
How is the respiratory system affected by pregnancy?
Progesterone acts centrally to reduce CO2 which increases tidal volume, resp rate, plasma pH and O2 consumption. Hyperaemia of respiratory mucous membranes occur
How is the GI system affected by pregnancy?q
Oesophageal peristalsis is reduced which slows gastric emptying and relaxes the cardiac sphincter.
How is GI motility affected during pregnancy?
It is reduced due to an increase in progesterone and motilin
What is the leading cause of maternal death in the UK?
Cardiac disease
What is the affect of folic acid on developing foetuses?
Reduces risk of developing spina bifida
What is involved in antenatal screening?
Routine enquiry, blood pressure, abdominal palpation, determine fetal presentation, listen to fetal heart
What infections are screened for during antenatal screening?
Hep B, Syphilis, HIV, UTI
What blood illnesses and immune issues are screened for during pregnancy?
Iron deficiency anaemia
Rhesus Disease
Anti-C and Anti-Kell
What anomalies are screened for during first scan?
Ensuring pregnancy is viable
Multiple Pregnancies
Identify abnormalities that are incompatible with life
Offer and carry out Down’s syndrome screening
What is a detailed anomaly scan?
Systematic structural view of baby, can identify problems that need intrauterine and postnatal treatment
What does a raised Nuchal Translucency indicate?
Increased risk of cardiac, renal or muscular problems
Combined with a blood test can identify down’s syndrome
When is CVS performed?
between 10-14 weeks
When is amniocentesis performed?
15 weeks onward
How is a NTD screened for?
Some are visible on a first trimester scan
Second trimester - blood test detects alpha fetoprotein and if high = high risk. US then performed to confirm
When is a second trimester ultrasound performed?
When an abnormality is detected
