HD1b

Question 1

what are early symptoms [4] and signs [3] of pregnancy?

Answer 1

symptoms

missed period
very light period with only a small volume of blood.
feeling tired
morning sickness
breast tenderness
visible veins on the breasts
urinary incontinence
strange tastes and cravings

signs
cervix appears plush rather than pink
uterus and cervix appear enlarged
breasts swollen and large with prominant superficial veins and darkening of areolae

Question 2

hCG is produced by WHAT? [1]

Answer 2

hcg produced by syncytiotrophoblast

Question 3

when are the different trimesters of pregnancy?

Answer 3

first trimester: 1-12 weeks

second trimester: 13 to 27 weeks

third trimester: 28 - 40 weeks

Question 4

which nutrtional changes should undergo before and during pregnancy? [5]

Answer 4

folic acid
vitamin D
iron
vitamin C
calcium

Question 5

explain why you need each of the following during pregancy:

folic acid
vitamin D
iron
vitamin C
calcium
protein

Answer 5

explain why you need each of the following during pregancy:

folic acid: 400micrograms. rbc synthesis; decreases risk of neural tube defects (spina bifida)/ green vegetables have folate (natural form)

vitamin D: 10 micrograms: regulates calcium and phosphate levels: teeth, bone development

iron: prevents risk of anaemia by increasing RBC

vitamin C:

calcium: makes babies teeth and bones
protein: supports tissue growth

Question 6

what do the following test for when screening pregnancy

ultasound:[1]

blood tests: [3]

both: [3]

Answer 6

ultasound: spina bidida

blood tests: SCA, HIV, hep B or syphilis

both: downs, edwards and pataus syndrome

Question 7

which tests are undergone during 20-week scan? (ultrasound) [11]

Answer 7

anencephaly

open spina bifida

cleft lip

diaphragmatic hernia

gastroschisis

exomphalos

serious cardiac abnormalities

bilateral renal agenesis

lethal skeletal dysplasia

Edwards’ syndrome, or T18

Patau’s syndrome, or T13

Question 8

which tests are undergone at 12-week scan? (aka dating scan) / what does it show?

Answer 8

1. how many weeks pregnant
2.1 or 1+ babies
3. baby in right place
4. baby development

can also screen for DS if want

Question 9

what is the name for the screening test for DS at 12 weeks? [1] what does it involve? [1]

Answer 9

The screening test for Down’s syndrome used at this stage of pregnancy is called the combined test

It involves a blood test and measuring the fluid at the back of the baby’s neck (nuchal translucency) with an ultrasound scan. This is sometimes called a nuchal translucency scan.

BUT: cant have the combined screening test after 14 weeks: not as accurate, but poses less harm to baby

Question 10

1. Describe the three phases of menstrual/uterine cycle (3 marks)

Answer 10

menstrual

1. menstrual: 1-5 days. menstrual flow. shedding of wall = implant cant occur
2. proliferative: ( follicular of ovarian)
3. secrative: corpus luteum produces progesteone for implantation. if doesnt occur. sheds (luteal of ovarian)

Question 11

2. Emily has an antenatal screening test to see if her baby has Down syndrome this is most likely to be the combined test. Briefly, describe the combined test and what is measured? (2 marks)

Answer 11

Nuchal translucency on the ultrasound (1/2 mark) = measure the fluid at the back of the baby’s neck (1/2 mark)

Blood sample measures amount of free beta-hCG (1/2 mark) and placenta associated plasma protein A (PAPP-A) (1/2 mark)

Question 12

3. What is the effect of the supine position on cardiac output and blood pressure of a pregnant woman? [2]

Answer 12

Enlarged uterus can cause compression of the vena cava which impedes venous return to the heart. [1]

This leads to a reduction in cardiac output and blood pressure (maternal hypotension). [1]

Question 13

4. Name three methods of contraception (3x½ mark) and describe how we measure the efficacy of a contraceptive (½ mark)? (2 marks)

Answer 13

combined pill
condom
progesterone pill

Contraception effectiveness is measured by how many women will get pregnant within a year of using that method = pearl index

Question 14

5. Name the substance that is measured when determining and confirming pregnancy and state where this substance is produced.[2]

Answer 14

hCG: produced from placenta - trophoblast cells that surround the embryo

Question 15

what is normal term for birth of pregnacny range? [1]
what is premature pregnancy? [1]
when is viable gestation? [1]

Answer 15

normal 37-40 weeks

premature: pre 37 weeks

24 weeks is viable gestation (born then and have a more than 50% chance of survival)

Question 16

which part of the hcG is detected in pregnancy test? [1]
which is the other part of hcG not detected and why? [1]

Answer 16

which part of the hcG is detected in pregnancy test? [1]
beta subunit

which is the other part of hcG not detected and why? [1]
alpha because its molecular structure v similar to LH and FSH (would give false positive)

Question 17

can you explain rhesus blood group testing?

Answer 17

can you explain rhesus blood group testing?

if mother is negative and the baby is positive: mother makes antibodies agaisnt the baby !

only a problem with the second pregnancy

Question 18

from tutor notes:

what are antenatal screening tests for the mother [4]
what are fetal well being tests [3]

Answer 18

what are antenatal screening tests for the mother [4]
weight
BP
FBC
urinalysis for protein, blood and glucose
rubella
HIV
ABO & Rh group

what are fetal well being tests [3]
fetal ultrasound to confirm viability, number, growth and normal anamoty

Question 19

tutor notes:

describe which antenatal care occurs during pregnancy

Answer 19

pregnant woman usually seen by GP to confirm pregnancy by 8 weeks

women is seen by a midwife every 4 weeks until 28 weeks of gestation.

goes up to 2 weeks up to 36 weeks

goes up 1 week after

Question 20

explain the mechanism of pregnancy test working [2]

Answer 20

• detect beta subunit of hCG in urine or blood
• ## alpha subunit hCG not detected (and is same as LH and FSH) - may give false negatives

Question 21

explain why a false negative pregnancy test may occur [1]
when is it advised to do pregnancy test from after the last period [1]

Answer 21

• too early (so not high enough hCG levels to occur)
• *- 28 days after last menstrual period**

Question 22

name a method apart from blood / urine tests that could detect pregnancy? [1]
when can the embryo be observed and measured by during this method? [1]
when is heartbeat detected? [1]

Answer 22

ultrasound
embryo detected at 5 & 1/2 weeks
heartbeat = 7 weeks