Antenatal Care and Screening Flashcards
When can morning sickness be worse?
In conditions where HCG is higher (eg. twins, molar pregnancy)
What can molar pregnancy progress to?
Hyperemesis gravidarum
What is a molar pregnancy?
An abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus and will fail to come to term
Cardiac problems in pregnancy
CO increases by 30-50%
Palpitations are a common complaint
Urinary problems in pregnancy
Increased urine output
UTI - increase in urinary stasis, hydronephrosis is physiological in the third trimester and makes pyelonephritis more common
Haematological problems in pregnancy
PV and RBC mass increases resulting in a drop in haemoglobin
WBC increases slightly
Platelet count falls by dilution
ANAEMIA
Respiratory problems in pregnancy
Progesterone acts to centrally reduce CO2, increased TV, RR, O2 consumption
Plasma PO2 unchanged
Hyperaemia of respiratory mucous membranes
GI problems in pregnancy
Oesophageal peristalsis is reduced
Gastric emptying slows
Cardiac sphincter relaxes
GI motility reduced due to increased progesterone and decreased motilin
Prepregnancy counselling
General health measures - diet, optimise BMI,reduce alcohol
Smoking cessation advice
Folic acid
Antenatal examination
Routine enquiry (feeling well/feeling foetal movements)
BP (detect evolving hypertension)
Urinalysis
WHich infections are screened for antenatally?
Hep B
Syphilis
HIV
MSSU
When is first trimester screeing?
10-14 weeks gestation
When is second trimester US and why is it performed?
20 weeks
For detecting foetal abnormality (mainly structural)
CO
Cardiac output
PV
Plasma volume
