Antenatal Factors

Question 1

What are teenage mothers more likely to do? And what does it put them at higher risk for?

Answer 1

Smoking and inadequate weight gain - premature births, low birth weight infants, iron deficiency anemia, preeclampsia/eclampsia, STDs, using alcohol/drugs (causing fetal abnormalities), lack of partner support

Question 2

what is cephalopelvic disproportion and who’s at risk for this?

Answer 2

mismatch size between the fetal head and the size of the maternal pelvis, results in a obstructed labor - teenage mothers

Question 3

what are women pregnant over 35 at risk for?

Answer 3

death associated with pregnancy increases with age (woman over 40 are 5 times more likely to die they under 25). Preexisting health increase problems such as placenta pre is, abruptio placenta, and spontaneous abortion. Down syndrome increases, marked increase past 40. Macrosomia and congenital malformations are more common

Question 4

what increases likely hood of multiple gestation?

Answer 4

IVF, ovulation inducing drugs, and age (past 30 years)

Question 5

what are infants born from multiple gestation at risk for?

Answer 5

prematurely, low birth weights. 50% of twins and 90% or triplets are born premature. low birth weights increases morbidities such as cerebral palsy and intellectual disability. increased risk for genetic disorders such as neutral tube defects, GI defects, and cardiac abnormalities is twice that in twins compared to single gestation

Question 6

what is a grand mulpartity?
what is great grand mulpartity?

Answer 6

-5 or greater deliveries of live or stillborn infants at or greater then 20 weeks
-10 or greater….

Question 7

what does grand multiparty put you at risk for?

Answer 7

Placenta pre is, abruptio placentae, preeclampsia, hemorrhage, C-section, fetal LGA/SGA, and breech. Poor prenatal care and increase risk for disease such as DM and HTN. Age also is a significant factor.

Question 8

Maternal stress impacts fetus and newborn how?

Answer 8

neuro development of fetus resulting in behavioral and neurological impairments of child. Fetuses have less variability in FHTs. If mother is depressed, fetus tends to be more active, if mother is anxious, less active

Question 9

Maternal smoking/alcohol effects on fetus and newborn?

Answer 9

-smoking can cause low birth weights, spontaneous abortion, placenta abruption, preterm birth, and developmental problems
-Alcohol cause FAS, cognitive and physical impairments, skeletal and organ malformations

Question 10

maternal exercise causes?

Answer 10

improved circulation, improved sleep, elevated mood, decreased duration of labor and prevents excessive weight gain. it can impair oxygenation in to fetus and there’s an increased risk for maternal falls

Question 11

Increased calorie intake during pregnancy?

Answer 11

none in first trimester, 300 more in 2nd-3rd trimester (600 for twins)

Question 12

daily iron intake for pregnant woman?

Answer 12

27 mg

Question 13

daily protein intake for pregnant woman?

Answer 13

71g

Question 14

daily fruit and vegetables intake for pregnant women?

Answer 14

2-4 fruits
3-5 vegetables

Question 15

mothers that are malnourished/under weight cause neonates to be at increased risk for?

Answer 15

low APGAR scores, low birth weights, and SGA.

Question 16

thiamine deficiency causes what in the developing fetus?

Answer 16

congestive heart failure, stillborns

Question 17

folic acid deficiency cause what in the developing fetus?

Answer 17

megaloblastic anemia, neural tube defects

Question 18

megaloblastic anemia

Answer 18

characterized by very large red blood cells that are underdeveloped in the inner contents

Question 19

neural tube defects

Answer 19

the neural tube does not close properly - happens very early in pregnancy. the two most common types are spinal bifida (spinal cord defect) and anencephaly (a brain defect)

Question 20

vitamin d and calcium deficiency causes?

Answer 20

skeletal defects

Question 21

infant of obese woman are at risk for?

Answer 21

macrocosmic, resp fetal distress, early neonatal death, meconium aspiration, shoulder dystocia, C-section

Question 22

how long should you wait post bariatric surgery to become pregnant and why?

Answer 22

-12-24 months
-maternal nutritional status needs to be monitored very closely before and during pregnancy

Question 23

how can anxiety effect effect pregnancy and labor?

Answer 23

anxiety increases perception of pain by triggering the release of catecholamines who go increase pelvic pain and maybe a major factor in labor pains. Increases muscle tension, decreased effectiveness of uterine contractions and prolongs labor

Question 24

benzodiazepines effects on fetus and newborn?

Answer 24

inconsistent studies in regards to birth defects or developmental/behavioral problems. neonates maybe have withdraw symptoms such as dyspnea, tremors, jitters, excessive crying and difficulty sleeping. Combining benzos with diphenhydramine may increase risk of stillborn

Question 25

buspirone effects on fetus and newborn?

Answer 25

little data regarding pregnancy is available but it’s classified as a Class B drug

Question 26

pregnancy classes for drugs?

Answer 26

-class A = no risk to human studies
-class B = no risk to animal studies
-class C = risk cannot be ruled out. no studies on humans but animal studies demonstrated risk to fetus
-class D = evidence of risk, studies on humans have demonstrated a risk
-class X = contraindicated

Question 27

SSRIs effects on fetus and newborn?

Answer 27

maybe cause persistent pulmonary HTN of newborn if taken during the last half of pregnancy. withdrawal symptoms maybe occur within 2 days or delivery and similar to those of benzos (dyspnea, tremors, jitters, excessive crying and difficulty sleeping)

Question 28

SNRIs effects on fetus/neonate?

Answer 28

similar to SSRIs but withdraw symptoms are less pronounced

Question 29

list alternative treatments for anxiety and depression during pregnancy?

Answer 29

bright light therapy, cognitive behavioral therapy, group therapy, relaxation exercises/visualization, support/reassurance, and exercise