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Reproductive > Antenatal Care And Screening > Flashcards

Antenatal Care And Screening Flashcards

1
Q

In what conditions can morning sickness in pregnancy be worse?

A

Where human chorionic gonadotropin is higher eg twin, molar pregnancy

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2
Q

What is hyperemesis gravidarum?

A

Excessive morning sickness and nausea which can require hospital treatment

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3
Q

What cardiac problems are common in pregnancy?

A

CO increases,
Palpitations,
In 2nd trimester blood pressure drops

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4
Q

Why does blood pressure drop in the second trimester?

A

Due to expansion of the uteroplacental circulation,
Fall in systemic vascular resistance,
Reduction in blood viscosity,
Reduction in sensitivity to angiotensin

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5
Q

Urinary system problems that can occur in pregnancy?

A

Increased urine output,

UTI

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6
Q

Why is there an increased urine output when pregnant?

A

Renal plasma flow increases,
Glomerular filtration rate increases,
Serum urea and creatinine decrease

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7
Q

What is it important to treat UTIs in pregnancy?

A

As hydronephrosis is physiological in 3rd trimester and can lead to pyelonephritis

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8
Q

Why do pregnant people experience anaemia?

A

Plasma volume increase by about 50% and RBC mass by 25%

Resulting in a drop in haemoglobin dilution

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9
Q

Why can pregnant women experience respiratory problems?

A

Progesterone reduces CO2,

And O2 consumption increases

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10
Q

Respiratory problems pregnant woman can experience

A

Increased respiratory rate,
Increased plasma pH,
Increased O2 consumption,
Hyperaemia of respiratory mucous membranes

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11
Q

Effects of pregnancy on the gastrointestinal tract?

A

Oesophageal peristalsis reduced,
Gastric emptying slows,
Cardiac sphincter relaxes

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12
Q

Why is GI motility reduced in pregnancy?

A

Increased progesterone and

Decreased motilin

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13
Q

GI symptoms in pregnancy

A

Heartburn,
GORD,
Constipation

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14
Q

Respiratory symptoms in pregnancy

A

SOB

Nose bleeds

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15
Q

Examples of pre-pregnancy counselling

A

General health measures (diet, BMI, alcohol),
Smoking cessation advice,
Folic acid (400mcg)

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16
Q

Previous pregnancy problems to consider in pre-pregnancy counselling?

A 
C-section,
DVT,
Pre-eclampsia,
Pre-term delivery,
Intrauterine growth restriction, 
Fetal abnormality
17
Q

Actions to reduce risk of recurrence of previous pregnancy problems?

A

Thromboprophylaxis,
Low dose aspirin,
High dose folic acid,
Treatment of infection

18
Q

Aim of antenatal examination?

A

Reduce fetal and maternal mortality

19
Q

Procedures carried out in an antenatal examination

A

Routine enquiry,
Blood pressure,
Urinalysis,
abdominal palpation

20
Q

What can you assess from abdominal palpation

A 
Assess symphysis fundal height, 
Size of baby estimate, 
Lie of fetus,
Liquor volume estimate,
Fetal presentation
21
Q

What are the 2 presentations of the fetus?

A

Breech and vertex

22
Q

After how many weeks is a breech baby offered a External Cephalic Version?

A

36 weeks

23
Q

What infections are pregnant women screened for?

A 
Hepatitis B,
Syphilis, 
HIV, 
UTI,
Rubella
24
Q

Iron deficiency anaemia and isoimmunisation (rhesus disease, Anti-c, anti-kell) are screened for in what condition?

A

Pregnancy

25
Q

At how many weeks do you get firs pregnancy scan?

A

11-14 weeks

26
Q

What is the purpose of 1st pregnancy scan?

A

Ensure viable,
If multiple pregnancy,
Identify abnormalities incompatible with life,
Offer/ carry out Down’s syndrome screening

27
Q

What conditions picked up in the 1st pregnancy scan are incompatible with life?

A

Anencephaly

28
Q

At how many weeks can you get a detailed anomaly scan?

A

20 weeks

29
Q

What is identified at detailed anomaly scan

A

Systematic structural review of baby,

Problems that need intrauterine or postnatal treatment

30
Q

Risk factors for Down syndrome in pregnancy?

A

Maternal age,

Personal or FH of chromosomal abnormality

31
Q

First trimester screening for Down’s syndrome

A

Maternal risk factors,
Serum B-human chorionic gonadotrophin,
Pregnancy associated plasma protein A,
Fetal nuchal translucency

32
Q

What is classed as high risk for Down’s syndrome?

A

risk of >1 in 150

33
Q

What are the further tests for Down’s syndrome after intital screen?

A

Chorionic Villus Sampling(sample from placenta),
Amniocentesis (sample from amniotic fluid),
Non-invasive prenatal testing (maternal blood tested for fetal cell free DNA)

34
Q

When are the majority of neural tube defects detected?

A

Second trimester scan

35
Q

What is the purpose of a second trimester ultrasound?

A

Detecting fetal abnormality

36
Q

How is date of delivery estimated?

A

1st trimester US by measuring the crown rump length

37
Q

What is the 1st sign of pregnancy on USS

A

Thickening of lining of the uterus

38
Q

Why might a 3rd trimester scan be requested?

A 
Position of baby, 
Fetal concerns eg gestational diabetes, 
Placenta concerns,
Check blood supply to baby,
Fluid surrounding baby check

Reproductive (2 decks)

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