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Y1&2 Medicine Zoe Veary > GUM 235 Pregnancy 2 > Flashcards

GUM 235 Pregnancy 2 Flashcards

1
Q

What increase in CO output is required in pregnancy and why?

A

30-50%

Due to the increased preload

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2
Q

What happens to HR in pregnancy?

A

Increases due to increase SV / preload

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3
Q

Why is the CO post-partum increased by nearly 80%?

A

Due to sudden increase in vascular resistance to prevent haemorrhage yet still increased blood volume

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4
Q

Why is there dyspnoea in pregnancy?

A

Rising fundus

Progesterone effect

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5
Q

What do you see on ECG in pregnancy?

A

sinus tachy and left axis deviation

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6
Q

What liver function test is raised normally in pregnancy?

A

ALP x1.5-2

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7
Q

What happens to protein levels in pregnancy

A

decreased: total protein, albumin and gamma globulin

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8
Q

What happens in a FBC in pregnancy?

A

neutrophillia,
decreased PLT,
increased RBC mass due to increase volume th. decreased hct / hb

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9
Q

Why is the female in a pro-thrombotic state during pregnancy?

A

To protect against post-partum haemorrhage

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10
Q

Why is there a compensatory respiratory alkalosis in pregnancy?

A

due to increased alveolar ventilation which facilitates fetomaternal oxygen transfer

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11
Q

What happens to kidney size and blood flow in pregnancy?

A

increased

therefore increased GFR - decreased urea and creatinine

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12
Q

What may altered tubular function in pregnancy result in?

A

glycosuria, proteinuria, calcium and bicarb in ?urine

th, UTI and pyelonephritis

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13
Q

Why can there be a transient hyperthyroidism in pregnancy?

A

B-HCG binds to the TSH receptor = increased T3 and T4

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14
Q

Why is there reflux in pregnancy?

A

prog decreases LOS tone

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15
Q

What are the RF’s for multiple pregnancy?

A

increased maternal age, fhx, race and assisted conception

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16
Q

monozygotic twins

A

identical - one zygote splits into two

17
Q

dizygotic twins

A

non-identical - 2 different zygotes

18
Q

dichorionic diamniotic (DCDA)

A

each twin has own chorion, placenta and amnion (always dizygotic)
Can be fused or separate

19
Q

monochorionic diamniotic (MCDA)

A

one placenta and chorion but two amnions

20
Q

monochorionic monoamniotic MCMA

A

one of everything between two!

21
Q

What are the risks of multiple pregnancy?

A

miscarriage, congenital abnormalilties,pre-term, IUGR

22
Q

What is the ABC before instrumental delivery?

A 
A= adequate analgesia
B = empty bladder
C = dilated cervix
23
Q

Where do you place the ventouse suction cap?

A

2-3cm anterior to posterior fontanelle

24
Q

What are the main causes of bleeding in early pregnancy?

A

ectopic or miscarriage

25
Q

What do you see in a threatened miscarriage ?

A

baby alive, os closed

26
Q

What do you see in inevitable miscarriage?

A

os is open

27
Q

How do you manage incomplete miscarriage?

A

Conservative
Medical : misoprostol and anti-D
Surgical

28
Q

What are some causes of bleeding in late pregnancy/ labour?

A

placental abruption - separation of placenta
placenta praevia - placenta covers LOS
ruptured uterus

29
Q

What are some causes of post-partum haemmorhage?

A

ruptured uterus,
uterine artery bleeding
trauma
retained placenta

30
Q

What is primary PPH?

A

bleeding occurs

31
Q

What is secondary PPH?

A

bleeding occurs >24-6 weeks post partum

32
Q

What are some risk factors for post-partum haemmorhage?

A

previous history, smoking, increased age, previous TOP, IVF, defective endometrium

33
Q

How would you managed PPH?

A

empty bladder, bimanual contraction, give oxytocis, repair surgically,

before delivery: group and save blood, IV access

34
Q

What are the three features of pre-eclampsia?

A

proteinuria, HTN and oedema

35
Q

What other features can you get with pre-eclampsia?

A

headache, vision distubrances, RUQ pain, N&V

placental ischaemia = decreased GFR and increased creat/urea

36
Q

What is HELLP syndrome in pre-eclampsia?

A

haemolysis, elevated liver enzymes, low platelets

= emergency - must deliver!

37
Q

What is the pathophysiology behind pre-eclampsia?

A

diffuse vascular endothelial dysfunction with circulatory disturbances involving multiple systems

affected by genetics

placental ischaemia in 1st half of pregnancy

abnormal placentation and trophoblast invasion

lack of vascular adaptation to pregnancy

Y1&2 Medicine Zoe Veary (60 decks)

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