Antenatal Care and Screening Flashcards
morning sickness is worse in patients with higher levels of what?
human chorionic gonadotropin
eg in twins or molar
cardiac output increases by what % in pregnancy?
30-50%
BP drops in which trimester (then comes back in which trimester)?
drops in 2nd and comes back in 3rd
what happens to urine output in pregnancy?
increases
also get increased UTIs due to urinary stasis
common problems in pregnancy:
increase urine increased cardiac output morning sickness anaemia increased respiratory rate reduced GI motility
gravidity
total number of pregnancies (regardless of the outcome)
parity
total number of pregnancies carried over the threshold of viability (24 weeks in the UK)
what is pre-eclampsia?
disorder of pregnancy characterised by a high BP and high protein levels in the urine
when does pre-eclampsia usually arise?
after 20 weeks of pregnancy
what can happen if pre-eclampsia is left untreated?
seizures
phenylketonuria
inborn error of protein metabolism (causes an inability to metabolise essential amino acid phenylalanine)
results in mental development impairment
(women should go on a low phenylalanine diet)
what measures do women with pre-existing type 2 diabetes need to take when pregnant?
they need to switch from oral medications to insulin
and optimise glucose control
if the baby is in breech - you can offer an ECV - what is this?
external cephalic version
attempt to turn the fetus so he/she is head down
what happens if ECV doesn’t work?
they are offered a c section
nullparity
no babies/ first baby
never carried a baby past 24 weeks
what would you counsel the mother on regarding HER risks of occurrence in pregnancy?
(maternal factors)
C section
DVT
pre-eclampsia
what would you counsel the mother on regarding the BABY’s risks of occurrence in pregnancy?
(fetal factors)
preterm delivery
intrauterine growth restriction
fetal abnormalities
when are feotal movements generally felt by the mother?
after 20 weeks
what tests would you do on the mother in antenatal care?
blood pressure
urinalysis
abdominal palpation (estimate size of baby, amniotic fluid level, Symphyseal fundal height)
check the lie of the baby
fetal heart
if baby is in breech after 36 weeks - what is offered?
external cephalic version
turned
what infections are all woman screened for prior to giving birth?
HIV
syphilis
rubella
UTI (MSSU)
Hep b
when is 1st trimester screening carried out?
weeks 10-14
1st trimester screening involves:
using maternal RFs
serum BHCG
PAPP-A (pregnancy associated plasma protein A)
fetal nuchal translucency
crown rump length
crown rump length
length of baby from head to buttocks
what is the antenatal screen for downs syndrome?
CUB screening
combined ultrasounds biochemical
What do you screen for in pregnant women?
Phenylketonuria (PKU)
Congenital hypothyroidism
sickle cell disorders
cystic fibrosis
PKU
baby cant break down phylalanine
sickle cell
abnormal Hb gene
CF
defect of cellular chloride transport
what are the symptoms/ signs in a child that they have fetal alcohol syndrome?
flat midface
small head
short nose
low nasal bridge
small eye openings
thin upper lip
underdeveloped jaw
what are the 3 classic signs of rubella?
sensorineural deafness
eye abnormalities
congenital heart disease
when is the first trimester?
until week 12
when is the second trimester?
week 13 - 27
when is the third trimester?
week 27 til end of pregnancy
