Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics > High Risk Pregnancy > Flashcards

High Risk Pregnancy Flashcards

0
Q

Advanced maternal age

A

Defined - >35yo, >40 =ivf
Increased risk for:
- med conditions - HTn, dm, thyroid
- fibroids, preterm threatened labour ( PTL)
- congenital abnormalities - trisomy 13,18,21
- m/c , ectopics, stillbirth, IUGR, lbw
- placenta abruption
- placenta praevia
- dysfunctional labour - failure to progress
- increased risk of c/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Obesity - risks to pregnancy

A
  • anaesthesia risks - GA, EPIDURAL
  • med risks - GDM, HTN, PET
  • m/c, stillbirths, congenital abnormalities
  • preterm labour, IUGR, IUFD,
  • macrosomia - labour complications - shoulder Dystocia, cpd
  • post term - increased risk of stillbirth
  • 2-3x increased risk of c/s: dvt, PE, wound infection, chest infection, OSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Grand multiparity

A

> p5

  • very quick deliveries
  • dysfunctional labour
  • at risk of PPH
  • mal presentations, unstable lie
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Previous pph

A
  • risk of repeat pph
  • reasons for pph -
  • active mx of 3rd stage labour :
    • Hb
    • group and hold
    • cord clamping and controlled traction with fundal support and signs of sepation - lengthening of cord, gush of blood, uterus becomes globular, fundus rises.
    • syntocinon vs syntometrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rh -ve blood grp

A
  • 10-15% of pregnancies
  • RISKS - with ISO-immunization - subsequent pregnancies - fetal hydrops
  • bleeding antepartum : 12k =625 IU IMI (within 72hrs)
  • antenatal prophylaxis: 28 and 34k 625IU
  • post partum :cord blood - group and Coombs; maternal - kleihauer for feto-maternal hemorrhage; anti-D 625 IU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Depression

A
  • 10% antenatally
  • 20% postnatally
  • baby blues vs PND
  • poor sleep/diet
  • poor bonding with baby
  • psychological support, may need antidepressants,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Teenage pregnancies

10-19yo

A
  • PET
  • PTL
  • anaemia
  • SGA/IUGR
  • barrier to ANC - concealed pregnancy
  • social and psychological factors
  • high risk group - STI, Poor contraception, barrier protection, substance abuse
  • low breast feeding rates
  • TOP/ adoption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Underweight

A
  • poor diet, lifestyle
  • malnutrition / deficiencies
  • SFA, IUGR
  • PTL
  • anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Drug use in pregnancy

A
  • fetal ETOH syndrome
  • IUGR
  • socio-economic
  • DOCS
  • APH, Placental abruption
  • PPROM, PTL
  • preterm delivery
  • IUFD, SIDS
  • behavioural consequences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Previous C/S

A
  • Reason for c/s
  • uterine rupture
  • repeat c/s vs VBAC
  • placenta praevia
  • placenta accreta
  • ectopic in c/s scar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

LGA

A
  • weight gain
  • GDM
  • CPD
  • shoulder Dystocia
  • birth trauma - mother and baby
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Twins

A
  • monochorionic vs dichorionic
  • m/c, congenital abnormalities
  • PTL and delivery
  • placenta praevia
  • TTTS
  • polyhydramnios
  • cord prolapse
  • malpresentation
  • GDM, HTN, Anaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indigenous pregnancy

A 
SOCIAL AND Psycho issues
Substance abuse and smoking
Poor diet
Maternal chronic diseases - DM, HTN, RENAL
GHT, GDM, - poor compliance
LBW
Teenagers, grand multiparity
High perinatal morbidity, mortality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Post term pregnancy

A 
>42k
Increased incidence of :
- still birth
- meconium
- low AFI
- placental insufficiency 
- non- reassuring CTG
- assisted delivery
- c/S
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antepartum haemorrhage

A

1) placenta praevia
- grade 1-4; minor or major
- 3% of pregnancies at term
- PAINLESS APH
- preterm delivery
- hysterectomy

2) vasa praevia
- 1/2500-5000 pregnancies
- fetal vessels run in membranes - APH =fetal hemorrhage
- high perinatal morbidity, mortality
- Preterm delivery

3) placental abruption
- premature separation of placenta prior to delivery of baby
- PAINFUL UTERUS, DARK CLOTS OR CONCEALED APH
- PPH , DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diabetes

A

Increased incidence of:

  • congenital abnormalities
  • macrosomia, IUGR
  • shoulder Dystocia
  • c/s
  • stillbirth
  • neonatal hypoglycaemia
  • MDT
  • plan delivery
  • follow up for GDM pt.s
16
Q

Infections

A

Hepatitis - B &C, acute vs chronic, vertical transmission
Chlamydia
Viral - rub, Cmv, parvovirus, herpes
UTI - recurrent, pyelonephritis,
Gbs - universal screening 32-34k, rom
- Risk based mx : prev infant with eogbsd, gbs bacteriuria, prom
>18hrs, preterm birth <37k, gbs colonisation
- colonisation - asso with asymptomatic bacteriuria, cystitis, intra-amnio infection, endometritis
- benzylpenicillin
- infant pneumonia, speticemia meningitis

17
Q

HTN

A
  • pre-existing : change med; increased risk of PET
  • GHT : 10-15% pregnancies; 140/90 on 2 separate occasions 6hrs apart
  • complications : PET, IUGR, PLACENTAL ABRUPTION
  • deliver at 38k
18
Q

Pet

A 
Rf:
>40yo - 2x
Obesity - 2x
Mother had PET - 20-25%
SISTER had PET - 35-40%
primigravida - 2-3x
Multiple preg - 2x
Prev pet - 7x
Long birth interval (10yrs) -2-3x
New partner -
19
Q

SLE/ autoimmune disorders

A

Increased risk PET

DRUGS

20
Q

Renal disease

A

Deterioration of renal funciton
Ptb
IUFD

21
Q

Clotting disorders

A

Claxane in pregnancy

22
Q

Cardiac disease

A

MDT

TIMEd and controlled delivery

23
Q

Thyrotoxicosis

A

1/500 pregnancies

If untreated - m/c, IUGR, ptl, perinatal mortality, fetal thyrotoxicosis, thyroid storm

24
Q

Hypothyroidism

A

1% of all pregnancies
Increase thyroxine
If untreated - m/c, anemia, fetal loss, pet, lbw, neurodevelopmental delay in offspring

25
Q

Incompetent cervix

A 
T2 fetal losses
Usually painless quick deliveries
Cervical cerclage (cervical stitch)
Serial cx length scans
Progesterone pessaries
26
Q

Uterine anomalies -Mullerian defects

A 
RPL
PTL
malpresentation
C/s
-IUGR
cord prolapse
27
Q

Malpresentation - breech

A

20% at 28k
3% at term
Frank, footling, complete
Risks - cord prolapse, head entrapment, injury

28
Q

Premature labour

A 
24-36+6k
7-10% of all deliveries
Previous PTB 
24k 50% survival
32k 98% survival
Risks 
- infections
- intra-cranial bleeds
- nec
- respiratory distress
- hypothermia
- hypoglycaemia
- CP
29
Q

PROM (preterm)

A
  • with or without labour
  • preterm: cord prolapse ; fetal malpresentation; pulmonary hypolasia; contractures
  • infections - chorioamnionitis
30
Q

IUGR

A

Fetal weight <2.5kg
High risk of - fetal distress; meconium ; IUFD
C/S vs SVD

Obstetrics (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions