Antenatal Complications Flashcards
What are the causes of abdominal pain in early pregnancy (<24 weeks)?
- Ectopic pregnancy
- Miscarriage
- Round ligament pain
- Acute urinary retention due to retroverted uterus
- Pregnancy-unrelated causes (e.g., Uterine/Ovarian causes, GI disorders, Urinary issues, Medical causes)
Includes conditions like ovarian torsion, constipation, gastric/duodenal ulcer, renal colic, and sickle cell disease.
What are the signs and symptoms associated with miscarriage?
- Lower abdominal dull ache to severe continuous or colicky pain
- Vaginal bleeding is present in most cases
- Positive urine pregnancy test, pelvic examination, and USS are helpful in diagnosis
USS refers to ultrasound scanning.
What are the key characteristics of ectopic pregnancy?
- Usually unilateral lower abdominal pain at <12 weeks gestation
- Associated with brownish vaginal bleeding
- Shoulder tip pain suggests haemoperitoneum
- Diagnosis: serum hCG, USS, and laparoscopy
hCG refers to human chorionic gonadotropin.
What typically causes round ligament pain during pregnancy?
Stretching of the round ligaments
Occurs in 20–30% of pregnancies, commonly in the 1st and 2nd trimester.
What is the management for constipation during pregnancy?
- High-fibre diet
- Osmotic laxatives
- Glycerin suppositories
Progesterone slows gut peristalsis, leading to constipation.
What are the signs and symptoms of uterine rupture?
- Tenderness over sites of previous uterine scars
- Foetal parts may be easily palpable
- Vaginal bleeding may be evident
- Signs of maternal shock may be present
- CTG may show foetal distress
CTG refers to cardiotocography, a method of monitoring fetal heart rate.
What is oligohydramnios and how is it diagnosed antenatally?
- Amniotic fluid index (AFI) <5th centile for gestational age or <8cm
- Deepest vertical pool (DVP) <2 cm
Oligohydramnios indicates too little amniotic fluid.
What are the major causes of oligohydramnios?
- Renal agenesis
- Urinary tract abnormality/obstruction
- IUGR and placental insufficiency
- Maternal drugs (e.g., NSAIDs)
- Post-dates pregnancy
IUGR refers to intrauterine growth restriction.
What are the complications associated with oligohydramnios?
- Pulmonary hypoplasia
- Limb deformities (contractures, talipes)
- Renal agenesis, multicystic kidneys, and urinary obstruction are lethal
These conditions are incompatible with life.
What is polyhydramnios and how is it defined?
AFI >95th centile or >20 cm or DVP >8
Polyhydramnios indicates excessive amniotic fluid.
What are the potential causes of polyhydramnios?
- Maternal diabetes
- Chorioangioma
- Multiple gestation and twin-twin transfusion syndrome
- Foetal hydrops
- Oesophageal atresia/tracheoesophageal fistula
Conditions like duodenal atresia and certain neuromuscular conditions can also contribute.
What are the normal fetal movement (FM) patterns?
- 10 FM in 2 hours
- FM can be felt from 16 weeks for multips; ≥20 weeks for primips
- Peak FM occurs in the afternoon, evening, and post-meals
- FM increases until 32 weeks, then stabilizes
Primip refers to a woman who is giving birth for the first time.
What are some maternal causes of reduced fetal movement?
- Infection
- Malnutrition
- Dehydration
- Alcohol
- Drugs
- Position
- Adiposity
- Perception
- Activity
- Smoking
IM refers to intrauterine maternal factors.
What is the definition of PROM?
Prelabour Rupture of Membranes: leakage of amniotic fluid in the absence of uterine activity
PROM can occur in three groups based on gestational age.
What are the classifications of caesarean sections?
- Category 1: Immediate threat to life
- Category 2: No immediate threat to life
- Category 3: Requires early delivery
- Category 4: At a time to suit the woman and maternity services
These categories help prioritize surgical interventions.
