Antenatal Care and Screening Flashcards
What is Hyperemesis Gravidarum ?
An extreme form of morning sickness which causes severe nausea and vomitting during pregnancy
By how many weeks should nausea and vomiting subsided ?
~16 weeks
During pregnancy cardiac output increases by how much ?
~30-50%
Why does blood pressure in the mother fall during the 2nd trimester ?
Expansion of the uteroplacental circulation.
A fall in systemic vascular resistance.
A reduction in blood viscosity.
A reduction in sensitivity to angiotensin.
By which trimester should the BP return to normal ?
3rd trimester
Why is the bladder capacity greatly reduced during pregnancy ?
Pressure in the pelvis due to expanding uterus
What occurs in the kidney during pregnancy with regards to the increased urine output ?
Renal plasma flow increases by 25-50%.
Glomerular Filtration Rate increases by 50%.
Serum urea & creatinine decrease.
Hydronephrosis is physiological in the 3rd trimester, true or false ?
True, increase in urinary stasis - pyelonephritis is more common.
Hydronephrosis is associated with pre-term labour, true or false ?
True
What causes anemia in pregnancy ?
Increase in RBC mass - ddrop in Hb.
Iron requirement increases by 1g.
When should iron supplements be given during pregnancy ?
If Hb is <110 or less than 100 on routine testing at 28 weeks
During pregnancy what happens to oesophageal peristalsis and gastric emptying ?
Peristalsis is reduced and therefore gastric emptying slows.
What causes the reduction in gastric motility ?
Increased progesterone
Decreased motilin
Progesterone acts centrally to reduce tidal volume . What will this increase ?
Resp. rate
Plasma pH
O2 consumption (by ~20%)
What is phenylketonuria (PKU) ?
an inborn error of protein metabolism which causes an inability to metabolism essential amino acid phenylalanine.
What do women with hypothyroidism do during pregnancy ?
Take thyroxine as the requirement of thyroxine increases during pregnancy - normal levels needed for foetal brain development
What do women with hyperthyroidism do during pregnancy ?
Thyroid stimulating antibodies can cross the placenta - check on foetus regularly
What kind of medication will a pregnant women be placed on if she is TIIDM ?
From PO medication to insulin for tighter diabetic control.
What is an antenatal abdominal examination comprised of ?
Asses symphyseal fundal height (SFH)
Estimate size of baby
Estimate liquor volume
Determine foetal position – listen to foetal heart
What infections are all pregnant women tested for ?
Rubella
Hep. B
Syphilis
HIV
What can rubella do to the unborn foetus ?
Mental handicap
Blindness
Deafness
Heart defects
What does congenital syphilis do to the unborn foetus ?
Causes intrauterine growth restriction, hepato-splenomegaly, anaemia, thrombocytopenia, skin rashes. Easily treated with penicillin with good outcome.
What is Rhesus disease?
Rhesus disease where anti-D antibodies occur. If a Rhesus negative woman is carrying a rhesus positive baby she will develop anti D antibodies if the foetal red blood cells enter the maternal circulation.
How do you treat Rhesus disease ?
Anti D IgG is offered to all Rh negative women both prophylactic after potential sensitizing events
What is the basis of the first foetal scan ?
Ensure viable pregnancy.
Identify abnormalities incompatible with life.
Offer and carry out down’s syndrome screening.
What is the basis of the detailed anomaly scan ?
Systematic structure review of baby.
Not possible to identify all problems
Can identify problems that need intrauterine or post-natal treatment.
How is Down Syndrome characterized ?
3 copies of chromosome 21
When is the 1st trimester scan carried out ?
10-14 weeks gestation
What is measured and is in line with the presence of a chromosomal disorder ?
Nuchal translucency
When can an amniocentesis be done ?
15 Weeks onwards
What trimester scan will detect 90% of neural tube defects ?
2nd trimester scan
Which scan is best for seeing structural abnormalities but not best for chromosomal abnormalities ?
2nd trimester scan
