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HD2 > Common Medical Problems Of Pregnancy Including Infections > Flashcards

Common Medical Problems Of Pregnancy Including Infections Flashcards

1
Q

What ethnic origins incr gestational diabetes risk

A

Asian
Indigenous
Pacific Islander
Hispanic
African

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2
Q

Gestational diabetes risk factors

A

Previous GD
family history of diabetes
Previous macrosomic baby
Previous unexplained stilbirth
Obesity
Glycosuria
Polyhydramnios
Large for gestational age

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3
Q

What causes foetal hyperinsulinaemia in GD and why

A

Incr maternal blood glucose
Ensure foetus gets enough glucose

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4
Q

Gestational diabetes

A

An exaggerated form of Carbohydrate intolerance of variable sensitivity with onset or first presentation in pregnancy

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5
Q

What causes a state of insulin resistance and glucose intolerance in normal pregnancy

A

Placental secretion of anti insulin hormones - HPL cortisol glucagon

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6
Q

What causes a mother with GD to return to pre pregnancy metabolic state

A

Birth (placenta delivered)

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7
Q

Pre pregnancy Determinants of insulin resistance

A

Ethnicity
Physical inactivity
Obesity
Dietary composition
PCOS
hypertension

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8
Q

Maternal Complications of GD

A

Hyper/hypoglycaemia
Pre eclampsia
Infection
Thromboembolic disease
Nephropathy
Retinopathy
Coronary artery disease
Poor wound healing

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9
Q

GD fetal complications

A

Macrosomia
Respiratory distress syndrome
Hypoglycaemia immediately after birth
Jaundice
Congenital abnormalities

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10
Q

What are fetal risks of macrosomia

A

Birth asphyxia
Traumatic birth injury
Shoulder dystocia

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11
Q

Normal birth weight

A

3.5 kg male
3.4 kg female

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12
Q

Why can babies of mothers with GD have hypoglycaemia immediately after birth

A

fetal hyperinsulinaemia due to hyperglycaemia in uterus from placenta delivering glucose, after birth glucose drops but insulin remains

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13
Q

GD management

A

Dietary modification
Calories reduction
Insulin
Mother with T2 switch from oral meds to insulin
Intrapartum monitoring
Ultrasound every 2 wks
Glucose tolerance testing 6-12 wks after delivery

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14
Q

What causes anaemia in pregnancy

A

Haemodilution

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15
Q

What is the main cause of maternal problems linked to anaemia in pregnancy

A

Bleeding at delivery

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16
Q

Anaemia treatment

A

Iron tablets or syrup
Iron infusion
Blood transfusion

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17
Q

What week of gestation is amniotic fluid highest

A

28th wk

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18
Q

Oligohydramnios

A

Deficiency in amniotic fluid
3rd trimester vol <300ml
Largest depth 2cm or less

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19
Q

What can cause oligohydramnios

A

Amniotic fluid leak
Fetal kidney abnormalities

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20
Q

Polyhydramnios

A

Excess amniotic fluid
>2000ml
Largest depth 8cm+

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21
Q

Causes of Polyhydramnios

A

Fetal GI or kidney abnormalities

22
Q

Is Polyhydramnios or oligohydramnios easier to treat

A

Polyhydramnios

23
Q

Potters facies/sequence

A

Flattened profile and badly developed hand muscles due to oligohydramnios

24
Q

Which infections are included in TORCH

A

Toxoplasmosis
Other
Rubella
Cytomegalovirus
Herpes simplex, HIV, hepatitis

25
Q

When is cytomegalovirus infection most likely to lead to congenital cytomegalovirus in a foetus

A

Primary infection during 1st trimester

26
Q

Congenital cytomegalovirus symptoms

A

Severe intrauterine growth retardation
Hepatosplemomegaly
Microcephaly
Sensorineural deafness

27
Q

Most common effect of congenital cytomegalovirus

A

Hearing problems - may not develop until childhood

28
Q

Why is rubella prevalence increasing

A

Decr MMR uptake

29
Q

How does rubella infection during pregnancy effect the fetus

A

Eye abnormalities - cataracts, glaucoma, strabismus, nystagmus, microphthalmia, iris dysplasia
Heart disease
PetechiaE and purpura
Microcephaly

30
Q

When can congenital toxoplasmosis occur

A

Mother newly infected during or just before pregnancy

31
Q

Congenital toxoplasmosis symptoms

A

Choriorentitis ———————\
Hydrocephalus ———————— classic triad
Intracranial atherosclerosis —/
IUGR
Microcephaly
Hepatolsplemomegaly

32
Q

How is congenital toxoplasmosis diagnosed

A

Maternal serology
Amniotic fluid PCR

33
Q

How is congenital toxoplasmosis treated

A

Pyrimethamine, sulfadiazine, and folic acid for mother and baby

34
Q

Symptoms of perinatal herpes infection

A

Skin lesions
65% mortality if untreated

35
Q

How is congenital CMV and congenital herpes treated

A

Antivirals(CMV) Antiretrovirals(HSV)

36
Q

Effects of neonatal group B streptococcus infection

A

Pneumonia
Meningitis
Non focal sepsis
Death

37
Q

Prevention of neonatal group B streptococcus infection

A

Antenatal detection - swabs and urine
Risk profiling
Benzylpenicillin during labour

38
Q

Maternal and fetal complications of UTIs in pregnancy

A

Maternal - pyelonephritis
Fetal - growth restriction, pre term labour

39
Q

UTI treatments

A

Penicillin
Cephalosporins
Nitrofurantoin

40
Q

What foods should pregnant women avoid to prevent listeriosis infection

A

Unpasteurised milk products
Undercooked meat
Unwashed vegetables

41
Q

Listeriosis symptoms in mother

A

Asymptomatic or indistinct virus symptoms

42
Q

Symptoms of congenital syphilis in under 2s

A

Rash
Rhinorrhoea
Osteochondritis
Perioral fissures
Lymphadenopathy
Pemphigus syphiliticus

43
Q

Congenital syphilis symptoms in over 2s

A

Hutchinson’s teeth
Clutton’s joints
Saber shins
High arched palate
Deafness
Saddle nose deformity
Frontal bossing

44
Q

opthalmia neonatorum

A

Watery eye discharge that can become copious and purulent, caused by congenital chlamydia or gonorrhoea infection

45
Q

Effects of chlamydia and gonorrhoea on fetus

A

Ophthalmia neonatorum
Pneumonia

46
Q

Congenital Chlamydia and gonorrhoea treatment

A

Azithromycin

47
Q

What cells are targeted by parvovirus B19

A

Erythrocytes

48
Q

Why is parvovirus B19 infection more serious before 20 weeks

A

Hemopoetic system in liver so easier to be infected
After 20 wks haemopoesis moves to bones so very little infection risk

49
Q

Congenital parvovirus B19 infection effect

A

Erythropoiesis arrested
RBC, lymphocyte, granulocyte, and platelet count decr
Hydrops fetalis
Fetal loss

50
Q

How can fetus be effected by Covid 19 infection in mother

A

Vertical transmission
Pro inflammatory cytokines can effect development

HD2 (23 decks)

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