Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction > Antenatal Care and Screening > Flashcards

Antenatal Care and Screening Flashcards

1
Q

Describe the antenatal care timeline

A

Booking scan before 10 weeks (8-12)

Dating scan 10-13 weeks (down syndrome/nuhal translucency screening also)

Antenatal appointment 16 weeks

Anomaly scan 18-20 weeks

28 weeks second screening for anaemia

Further antenatal appointments at 25, 31, 34, 36, 38 etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is covered at routine antenatal appointments?

A

Symphisis-fundal height measurement from 24

Fetal presentation from 36

Urine dipstick and protein

BP

Urinalysis, for asymptomatic bacteriuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What bloods are done at booking?

A

FBC

  • Anaemia

Haemoglobinopathy

  • Thalassaemia, for all women
  • Sickle cell, for women at high risk

Blood group

Rhesus status

Viral screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When are women screened for anaemia in pregnancy?

A

Booking

28 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why does anaemia occur in pregnancy?

A

During pregnancy, the plasma volume increases, and so the blood is more diluted, resulting in reduced haemoglobin concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What dose of folic acid is reccomended in pregnancy?

A

400mcg

Women with neural tube risk factors should be given 5mg instead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What supplements, other than folic acid, should also be advised for pregnant women?

A

Vitamin D 10 micrograms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What supplements are not reccomended in pregnancy?

A

Vitamin A in high doses can be teratogenic

(Liver is high in this so should also be avoided)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What foods should be avoided in pregancy?

A

Vitamin A

  • Liver

Listeriosis

  • Unpasteurised milk
  • Ripened soft cheeses
  • Pate
  • Undercooked meat

Salmonella

  • Raw or partially cooked eggs and meat, especially poultry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What medications cannot be used in pregnancy?

A

Methotrexate

Lithium, avoided unless other options have failed

Sodium valproate

DOACs

ACEI/ARBs

B Blockers, switch for labetalol

NSAIDs typically avoided unless necessary

Opiates, can cause neonatla withdrawl

Warfarin

Roaccutane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should methotrexate be stopped before conception?

A

Both men and women must stop methotrexate 6 months prior to conception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When should NSAIDS be stopped in pregnancy?

A

May be used until 32 weeks but after this time should be withdrawn due to the risk of early close of the ductus arteriosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What anti-depressants are used in pregnancy and breast feeding?

A

Sertraline or paroxetine are the SSRIs of choice in breastfeeding women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the safest epileptic drugs to use in pregnancy?

A

Carbamazepine and lamotrigine

Sodium valporate carries the highest risk of congenital defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give drug contraindications for breastfeeding

A

Antibiotics

  • Ciprofloxacin
  • Tetracycline
  • Chloramphenicol
  • Sulphonamides

Lithium

Benzodiazepines

Aspirin

Carbimazole

Methotrexate

Sulfonylureas

Cytotoxic drugs

Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the pathophysiology of rhesus disease in pregnancy

A

If a Rh -ve mother delivers a Rh +ve child, a leak of fetal red blood cells may occur

This causes anti-D IgG antibodies to form in mother

In later pregnancies, these antibodies can cross the placenta and cause haemolysis in fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is anti-D immunoglobulin therapy given in pregnancy?

A

Delivery of a Rh +ve infant, whether live or stillborn

Any termination of pregnancy

Miscarriage if gestation is > 12 weeks

Ectopic pregnancy if managed surgically

External cephalic version

Antepartum haemorrhage

Amniocentesis, chorionic villus sampling, fetal blood sampling

Abdominal trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When should anti-d therapy be given to unsensitised Rh - mothers?

A

28 and 34 weeks

19
Q

What infections are screened for in pregnancy?

A

HIV

Rubella

Hep B

Syphillis

20
Q

What vaccines are offered to pregnant women?

A

Whooping cough/pertussis) from 16 weeks

Influenza when available in autumn or winter

21
Q

What organism causes Rubella?

A

Togavirus

22
Q

How does congenital rubella syndrome present?

A

Aqueductal stenosis and congenital hydrocephalus

Sensorineural deafness

Congenital cataracts

Congenital heart disease/patent ductus arteriosus

Congenital cataracts

Growth retardation

Hepatosplenomegaly

Purpuric skin lesions

Chorioretinitis

Microphthalmia

Cerebral palsy

23
Q

When is there a risk of congenital rubella syndrome?

A

In first 8-10 weeks risk of damage to fetus is as high as 90%

Damage is rare after 16 weeks

24
Q

When are Rubella patients infectious?

A

Individuals are infectious from 7 days before symptoms to 4 days after the onset of rash

25
Q

When is the MMR vaccine offered?

A

Offered in post natal women but not offered to pregnant women or those attempting to get pregnant

26
Q

Describe the management of chickenpox exposure in pregnancy

A

If less than 20 weeks and not immune, give varicella zoster immunoglobulin (VZIG) as soon as possible, effective up to 10 days post exposure

If more than 20 weeks and not immune, give either VZIG or aciclovir 7-14 days after exposure

If any doubt on the patient having previous chickenpox, check for varicella antibodies

27
Q

Describe the managemet of chickenpox in pregnancy

A

If over 20 weeks and presenting within 24 hours of onset of rash, give aciclovir

If less than 20 weeks aciclovir should be given with caution

28
Q

How does congenital varicella zoster virus present?

A

Low birth weight

Limb hypoplasia

Skin scarring

Microcephaly

Eye defects

Learning disability

29
Q

What is the management of pregnant mothers who are hepatitis B positive?

A

Babies should receive vaccination at 1-2 months and 6 months and hepatitis B immunoglobulin within 12 hours of birth

Little evidence to suggest caesarean section reduces vertical transmission rates

hepatitis B cannot be transmitted via breastfeeding

30
Q

What is the management of pregnant mothers who are HIV positive?

A

Zidovudine infusion should be started four hours before beginning the caesarean section

Zidovudine administered orally to neonate

Advised not to breastfeed

31
Q

What is asymptomatic bacteriuria and what is the relevance in pregnancy?

A

Refers to bacteria present in the urine, without symptoms of infection

Pregnant women with asymptomatic bacteriuria are at higher risk of developing UTIs and pyelonephritis, and subsequently at risk of preterm birth

32
Q

How are UTIs managed in pregnancy?

A

7 days of antibiotics

Nitrofurantoin, avoid in the third trimester due to neonatal haemolysis

Amoxicillin, only after sensitivities are known

Cefalexin

33
Q

Why should cats be avoided in pregnancy?

A

Toxoplasmosis

34
Q

Why should unpasturised cheese be avoided in pregnancy?

A

Listeria monocytogenes/listeriosis

35
Q

What causes increased alpha feto protein?

A

Neural tube defects

  • Meningocele
  • Myelomeningocele
  • Anencephaly

Abdominal wall defects

  • Omphalocele
  • Gastroschisis

Multiple pregnancy

36
Q

What causes decreased alpha feto protein?

A

Down’s syndrome
Trisomy 18/Edward’s syndrome
Maternal diabetes mellitus

37
Q

Give risk factors for neural tube defects

A

Previous child with NTD

Diabetes mellitus

Women on antiepileptic

Obese

HIV +ve taking co-trimoxazole

Sickle cell

38
Q

What causes increased nuhal translucency?

A

Down’s syndrome

Congenital heart defects

Abdominal wall defects

39
Q

What tests are used in down syndrome screening?

A

Increased serum b-human chorionic gonadotrophin (b-hCG)

Decreased pregnancy associated plasma protein A (PAPP-A)

Increased fetal nuchal translucency (NT) measurement

40
Q

What are the air travel rules in pregnancy?

A

Women over 37 weeks with singleton pregnancy and no additional risk factors should avoid air travel

Women with uncomplicated, multiple pregnancies should avoid travel by air over 32 weeks

41
Q

How does fetal alcohol syndrome present?

A

Microcephaly (small head)

Thin upper lip

Smooth flat philtrum (the groove between the nose and upper lip)

Short palpebral fissure (short horizontal distance from one side of the eye and the other)

Learning disability

Behavioural difficulties

Hearing and vision problems

Cerebral palsy

42
Q

What vaccinations are offered to pregnant women?

A

Pertussis and influenza

43
Q

Give complications of CVS

A

Foetal limb abormalities if performed before 11 weeks gestation

Reproduction (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions