Common Complications in Pregnancy Flashcards
What are some minor symptoms of pregnancy?
- Nausea/vomiting
- Constipation
- Back pains
- Breast tenderness
What is an ectopic pregnancy?
When the embryo implants itself in the uterine tube, outside the uterus.
What is hyperemesis gravidarium?
Excessive nausea & vomiting
What are some common complications in the second & third trimester of pregnancy?
- UTI
- Anaemia
- Pre-eclampsia
- Gestational diabetes
What is intrauterine growth restriction (IUGR)?
It is when the baby fails to reach its growth potential during its current stage in the pregnancy
What is macrosomia?
A baby born with excessive weight
Why are women prone to UTIs during pregnancy?
Because the mass in their pelvis presses on their bladder/uterus, which blocks the urinary tract tubing leading to increased risk of infections.
Why is anaemia common in pregnant women?
Because the conc. of haemoglobin in pregnant women falls due to the baby being present, so their plasma vol. increases and dilutes the blood even more, causing anaemia.
At what point in pregnancy is the blood fully diluted, and should be when anaemia is tested?
At 28 weeks.
How is anaemia in pregnancy treated?
- Investigate the cause first as it could be from: low serum ferritin/B12/folate.
- Ferrous sulphate if already anaemic before pregnancy
- Blood transfusion if <7 or symptomatic
How can you distinguish between pre-existing and gestational diabetes?
If the woman has been tested for diabetes <20 weeks after conception, then she has pre-existing diabetes.
If she is tested for diabetes >20 weeks after conception, then this is gestational.
How is gestational diabetes caused in pregnancy?
Pregnancy can initiate cortisol/glucagon/other hormones in the placenta, which induces insulin resistance.
Which women are more susceptible to gestational diabetes?
- Obese
- Previous baby >4.5kg
- Previous gestational diabetes
- PCOS
- Family history of diabetes
Why is gestational diabetes screened after 20 weeks?
Because screening too early can result in missing the diagnosis.
How can hyperglycaemia in pregnant women cause birth defects?
If the mum is hyperglycaemic, glucose can quickly cross the placenta towards the baby, also making them hyperglycaemic & eventually causing defects.
Why can a baby potentially be born hypoglycaemic if the mum was hyperglycaemic?
Because when the baby is born and the umbilical cord is cut, the baby is not receiving sugars from the mum anymore, which can cause hypoglycaemia.
What can macrosomia (overweight babies) cause for the woman?
- Prolonged labour
- Pre-eclampsia
- Operative delivery (caesarian)
How can gestational diabetes be managed?
- Counselling pre-pregnancy if they are already diabetic
- Achieve normal blood sugar levels
- Diet
- Metformin
- Insulin
What is pre-eclampsia (PET)?
It is a very high BP during pregnancy on 2 separate occasions + proteins present in the urine.
What differentiates if the woman already has high BP, or pre-eclampsia?
If they are tested for high BP <20 weeks after conception = then it is pre-existing
If they are tested for high BP >20 weeks after conception = pre-eclampsia
What 2 drugs are used to treat pre-eclampsia?
Nifedipine and labetalol
What test is given to test for proteins in the urine?
Urine dip-stick
When does oedema in pregnant women become a concern?
When oedema occurs in unusual sites (besides the feet/legs)
What happens to blood pressure in a normal pregnancy?
BP decreases in normal pregnancy due to a drop in peripheral resistance to accomodate for the extra cardiac output.
High volume blood + low pressure = normal physiology in pregnancy
At what point in pregnancy does BP start to normalise?
During the 3rd trimester.
What happens to blood vessels during pregnancy?
They become sticky, leaky & tight (due to abnormal epithelial lining)
What can reduced placental perfusion in pregnancy cause for the baby?
Fetal death or defects, e.g.:
- Reduced renal fetal perfusion
- Reduced urine fetal perfusion
- Rapid weight loss of baby
- Reduced fetal nutrition
