High Yield Pregnancy content Flashcards
What is the risk of HIV transmission in pregnancy?
Low risk with use of antiretroviral medication, delivery of C section and no breastfeeding.
What is the most common cause of postpartum haemorrhage?
Uterus atopy.
What is the role of round ligament?
Connects the uterine fund us to the labia Majora.
What is an ectopic pregnancy?
Pregnancy which occurs outside the uterine tube This commonly occurs in the ampulla which is the widest part of the uterine tube. If this occurs in the isthmus, rupturing is likely.
How does ectopic pregnancy present?
Severe abdominal pain and vaginal bleeding. Pain in the shoulder tip due to blood in the peritoneal cavity irritating the diaphragm.
What is a molar pregnancy?
Abnormal fertilisation where:
-> polyspermy occurs
->sperm fertilise an egg which may have no maternal genetic information
This can result in excessive growth of the trophoblast which can lead to tumour formation in the uterus.
What is trophoblastic disease?
Trophoblast cells of placenta which invade the uterine wall to become cancerous This is a risk for hyperesmesis gravidarum.
What are the invasive screening antenatal tests?
Chorionic villus sampling
Amniocentesis.
What is a non invasive screening antenatal tests?
Analysis of maternal blood which contains DNA fragments for free-floating foetal DNA.
What is the most common type of monozygotic twin pregnancy?
Dichorionic pregnacy- this is where cleavage occurs before implantation.
Why does monoamniotic pregnancy occur?
Cleavage occurs after implantation so only one trophoectoderm differentiates.
What is hyperesemesis gravidarum?
Excessive nausea and vomiting during pregnancy which has a greater risk if:
Multiple babies
Trophoblastic disease
Younger women
What is placental abrutpion?
Separation of the placenta from the uterus which can occur due to shear force trauma or infection. This can cause abdominal pai and uterine contractions.
What is pelvic inflammatory disease?
Inflammation of the pelvis which leads to scar tissue formation and adhesion, that can lead to difficulty getting pregnant. This can occur commonly following gonorrhoea or chlamydia bacterial infection in the past.
What are the hormones in menopause?
High FSH and LH and low oestrogen
What causes folic acid deficiency?
Excess alcohol
Methotrexate use
Phenytoin
Pregnancy
What is phenytoin?
Medication used to prevent seizure
What is methotrexate?
Anti-neoplasticism drug which is also used to treat psoriasis and rheumatoid arthritis. It inhibits dihydrofolate reductase for nucleotide synthesis.
What is Chorioamnionitis?
Infection of the amniotic fluid due to the ascending bacteria from the vagina and cervix. This causes foul-smelling discharge, abdominal pain and fever and abdominal contraction.
What is pre-eclampsia?
Hypertension that occurs after 20 weeks gestation that leads to risk of development of seizures. It cannot be treated other than foetus delivery
What are the features of pre-eclampsia?
Hypertension occurs due to insufficient spiral artery remodelling, with vasoconstriction also resulting in endothelial dysfunction and platelet formation.
HELP:
H:haemolysis of RBC
E: Elevated
L: Liver enzymes
P: platelet count low
How is pre-eclampsia treated?
Delivery will alleviate but low molecular weight heparin can be given as a thromboprophylaxis.
Turner syndrome
45 X chromosome that results in short stature and infertility. There is hypergonadotrophic gonadism.
What does smoking protect against?
Endometrial cancer
What is a risk for Erb’s palsy?
Macrosomia
-> Increased risk with maternal diabetes and high maternal BMI
How does body temperature change during menstruation?
Body temperature rises at ovulation. If high temperature is maintained, it indicate fertilisation because progesterone is responsible for temperature changes.
When is body temperature lower in the menstrual cycle?
Follicular phase
What is the innervation of the breast?
T4 to T6.
How does anaemia occur in pregnancy?
Blood dilution due to high plasma volume.
What is the most effective contraception?
Progesterone implant
What causes pelvic pain in pregnancy?
Pubic symphysis dysfunction.
What are the causes of postpartum haemorrhage?
4 T’s
Uterus atony
Retained placenta
Thrombosis
Perineal tear
What are the risk factors for post-partum haemorrhage?
Pre-eclampsia
Prolonged labour
Higher maternal age
Macrosomia
Polyhydroamniosis
What is endometriosis?
Endometrial tissue grows outside the uterus that can lead to intense pain during menstruation, intercourse and pain during defaecation. The pain can occur due to bleeding from the extra endometrial tissue.
What is the Pouch of Douglas?
Rectouterine pouch
What is the efffect on GFR in pregnancy?
Increases and tubular reabsorption of glucose occurs that leads to glucose in urine.
What is the cause of jaundice 24 hours after birth in newborns?
Haemolytic disease of the newborn
What is the cause of jaundice 72 hours after birth?
Breastfeeding
What is haemolytic disease of newborn?
Breakdown of RBCs in newborns that leads to bilirubin buildup which causes Jaundice. This can occur due to incompatibility of blood types between the mother and baby, such as rhesus disease.
Which medication is send to treat hypertension in pregnancy?
Labetalol
When is ramipril given in pregnancy?
Contraindicated in pregnancy.
How does oestrogen afffect the vagina micro biome?
Maintains acidity by increasing levels of bacteria lactobacilli to form lactic acid.
What is breast milk deficient in?
Vitamin K
What is the role of lactoferrin in milk?
Iron absorption.
What causes drop in Hb levels f=during pregnancy?
Dilution due to higher plasma volume.
What is adenomyosis?
Presence of ends=ometrium in the myometrium which causes heavy bleeding.
