Antenatal Care and Screening Flashcards
explain morning sickness
affects around 80% of women
worse in conditions where HCGT is higher eg twins
lead to hypermesis gravidarum
usually better after 16 weels
how does pregnancy affect cardiac
CO increases by 30-50%
heart rate increases 70-90
palpitations
how does pregnancy affect blood pressure
DROPS in the second trimester expansion of uterioplacental circulation a fall in systemic vascular resistance reduction in blood viscosity reduction in senssivhty to angiotensin
how does pregnancy affect urine output
increases
renal plasma flow increases
GFR increases
creatinine decreases and serum urea
does pregnancy increase risk of UTI
yes
more urinary stasis
hydronephoris
how does pregnancy affect blood
increased iron requirement iron supplements if <110 hb drop in hb from 133-121 platelets fall WBC increases
how does pregnancy affect respiratory
increase RR as progesterone reduces CO2
plasma pH increases
SOB
how does pregnancy affect Gi
peristalsis reduced-heartburn
gastric emptying- constipation
who is pre-preganncy counselling for
all women, previous health or pregnancy issues
what are general advice givne
improve diet smoking cessation folic acid optimise mental health BMI
how are diabetic pregnant women managed
switched to insulin
what are renal patients more at risk of
pre-eclampsia
what is the risk of peolewith epilspey
sodium valproate is associated with spina bifida
what should happen if a woman has had 2 sections
always deliver by a section, if only one due to breech baby should be fine with normal labour
what is the point in an antenatal exmaination
reduces feta and maternal mortality
check fetal abnormality
fatal size
what are routine things to check
feeling unwell? BP urinalysis abdominal palpation-measure bump and size of baby assess lie
what is antenatal screening
testing of a symptomless population in order to detected.a disease at age early stage
what infecitons are screened for
hep B
syphilis treated with penicillin
HIV
MSSU-UTI
why is the blood screened
for iron deficiency aneamia
rhesus disease
screening for anomalies
multiple grenancies
Down syndrome
fatal abnormalities
what is a detailed anomaly
systemic structural review of the bay
explain screening for down syndrome
chromosomal abnormalities
3 copies of 21
maternal age and family history increases risk
must be aware the test just shows risk
when is first trimeter USS carried out
10-14 weeks gestation
fetal nuchal translucency measurement -crown to rump
what otpions are there with a high risk result
further testing
CVS -chorionic villus sampling
amioncentesis
