Maternal and foetal wellbeing Flashcards
What are the main causes of birth defects?
Most commonly, aetiology is unknown (approx. 50%) Multifactoral inheritance (approx. 25%) Environmental agents, drugs and viruses Mutant genes Chromosomal abnormalities
When are embryos most susceptible to defects?
Approx. weeks 3-14 (when a lot of women don’t know they are pregnant)
What is the difference between a structural and functional abnormality?
Structural = physical problem with body part (e.g. cleft lip) Functional = problem with the function of a system (e.g. developmental disabilities)
What are the common symptoms of pregnancy in the first trimester?
Morning sickness caused by rising hCG
Increased frequency micturition due to the vascularity of of the bladder - lasts until approx. week 16 when the gravid uterus rises out of the pelvic girdle
What is Hyperemesis Gravidarum?
Severe morning sickness - present in 3.6% of pregnancies
What symptoms are common later in pregnancies?
Heartburn Constipation Vaginal discharge (leucorrhoea) Skin changes (hyperpigmentation of pregnancy) Backache (caused by loosening of ligaments and altered posture) Symphysis Pubis Dysfunction Leg cramp Carpal Tunnel Syndrome
What causes constipation in pregnancy?
Increased progesterone causes reduced gastric motility
What is leucorrhoea?
White, non-irritant, non-offensive discharge
What is gravidity?
Total number of pregnancies, including current pregnancy (twins etc. count as one)
What is parity?
The number of livebirths or stillbirths after 24 weeks gestation (each child counted individually in cases of multiple births)
What needs to be done to minimise risk of prematurity or stillbirth?
Monitor growth - identify intrauterine growth restriction
Identify anomalies
Prevent/ intervene/ deliver/ preparation
What pharmacological management can be used if there is a risk of prematurity?
Magnesium sulphate (neuroprotectant - reduces risk of cerebral palsy) Steroids (e.g. Betamethasone) - stimulates synthesis of surfactant and prevents bleeding in baby's brain and lowers risk of necrotising enterocolitis
What are biometric and biophysical tests useful for?
Biometric tests predict foetal size at point of gestation - periodically can indicate growth but not foetal wellbeing
Biophysical tests (e.g. Doppler) can predict foetal wellbeing but not growth
What foetal biometric parameters can be used to predict foetal size?
1st trimester = crown rump length
2nd trimester onwards = head circumference, abdominal circumference, femur length
What are the potential risks of intrauterine growth restriction?
Stillbirth Low birth weight Decreased oxygen levels Hypoglycaemia Hypothermia Less resistant to infection Difficult vaginal delivery Foetal tachycardia
