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B5 > Maternal And Foetal Wellbeing > Flashcards

Maternal And Foetal Wellbeing Flashcards

1
Q

What weeks is an embryo at most risk from teratogens?

A

3-14/40 (when they don’t know they’re pregnant)

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2
Q

What’s structural and functional abnormality?

A

Due to teratogens

Structural abnormality = problem with body part development eg cleft lip or neural tube defect

Functional abnormality = problem with how a body part/system works eg developmental disabilities

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3
Q

During which trimester is the embryo most susceptible to teratogens?

A

First trimester (first 12 weeks/3 months)

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4
Q

What’s toxoplasmosis?

A

Can cause miscarriage
Teratogens
Cat poo found in soil/cat litter

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5
Q

What food can be a teratogen?

A

Mould ripened cheese eg blue cheese

Listeria bacterium -> miscarriage/stillbirt

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6
Q

What are common symptoms in the first trimester of pregnancy?

A

Morning sickness due to rising hCG levels
Hyperemesis gravidarum (hospitalised morning sickness)
Increased frequency of micturition

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7
Q

Why is there increased frequency of micturition during pregnancy?

A

Due to increased vascularity of the bladder (lasts until 16/40 when the uterus rises out of the pelvic girdle)

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8
Q

What are 3 ways to date a pregnancy?

A

From the last menstrual period (first day)
Crown rump length at early sonogram
Fundus-symphysis height from week 24

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9
Q

What are symptoms during the later stages of pregnancy?

A 
Periodontal disease
Heartburn
Constipation (rising progesterone = reduced gastric motility)
Haemorrhoids
Vaginal discharge (leucorrhoea = normal)
Hyperpigmentation of skin
Backache
Symphysis pubis dysfunction
Leg cramp
Carpal tunnel syndrome + oedema in the carpal tunnel
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10
Q

What are some basic recommendations to improve health of childbearing women and their infants?

A 
Improve maternal nutrition
Reduce levels of smoking
Reduce alcohol consumption
Increase exercise
Reduce incidence of premature births
Increase incidence of healthier neonates
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11
Q

What’s Gravidity and Parity?

A

Gravidity = total number of pregnancies including the current one

Parity = number of live/still births after 24 weeks gestation (anything else counted as +1)

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12
Q

What’s the obstetric history of a woman with a GPA of G3 P3

A

Has been pregnant 3 times

Given birth 3 times

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13
Q

How is GPA expressed to a woman with one child and twins, who has never been pregnant another time

A

G2 P3

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14
Q

How many births will be premature? What’s stillbirth thought to be related to?

A

10%

Stillbirth thought to be linked to intrauterine growth restriction

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15
Q

What are 3 potentially modifiable factors for reducing stillbirths?

A

Obesity
Smoking
Foetal growth restriction

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16
Q

What are the 3 categories of birth weight?

A

Average 3.2 kg
Small under 2.5 kg
Large over 4.5 kg

17
Q

Define prematurity - what are the 3 categories?

A

A baby that is born before 37 weeks

Extremely preterm less than 28 weeks
Very preterm 28-32 weeks
Moderate-late preterm 32-37 weeks

18
Q

What are two drugs that can be used if there is a risk of prematurity?

A

Magnesium sulphate = neuroprotectant role in cerebral palsy

Steroids (Betamethasome) = prevents bleeding on the brain; lower risk of necrotising enterocolitis; stimulates synthesis of lung surfactant

19
Q

When do you have a steroid injection during pregnancy?

A

24-34 weeks double dose

34-37 weeks

20
Q

What’s the difference between biometric and biophysical tests?

A

Biometric tests predict size at a point in gestation

Biophysical tests predict foetal wellbeing (eg Doppler)

21
Q

What are foetal biometric parameters during the first and second trimesters?

A

First trimester: crown rump length used in early pregnancy

Second trimester scans onwards:
Biparietal diameter
Head circumference
Abdominal circumference
Femur length
22
Q

What are risks of intra-uterine growth restriction?

A 
Low birth weight
Decreased O2 levels
Hypoglycaemia
Hypothermia
Less resistant to infection
Difficulty handling vaginal delivery
23
Q

What are types 1 and 2 IUGR and their causes?

A

Type 1 = all foetal biometrics less than expected
Caused by infection or chromosome abnormalities

Type 2 = disproportion between parameters, abdominal circumference classically affected
Caused by placental insufficiency, pre-eclampsia

24
Q

What’s biophysical profiling?

A

Combines non-stress test with ultrasound to check health of foetus - measures foetal heart rate in response to foetal movements

25
Q

What can biophysical profiling assess?

A 
Foetal heart rate
Foetal breathing
Foetal movements
Foetal tone
Amniotic fluid volume
26
Q

At what weeks does swallowing start in the foetal GI system? What does foetal swallowing regulate?

A

10-12

Amniotic fluid volume is regulated by swallowing

27
Q

What’s meconium?

A

Baby’s first stool = dark green black gut debris as it accumulates in foetal gut

28
Q

How is foetal waste excreted?

A

Via the placenta

29
Q

How is the foetal urinary system monitored?

A

Foetal kidney number/size/structure
Amniotic fluid volume
Bladder activity

30
Q

When does foetal urine add to the amniotic fluid?

A

After week 20 (in latter pregnancy majority of amniotic fluid volume is foetal urine)

31
Q

How does the volume of amniotic fluid change throughout pregnancy?

A

10ml at 8 weeks
1L at 38 weeks
Falls to 300ml at 42 weeks

32
Q

What’s polyhydramnios and oligohydramnios?

A

Too much and too little amniotic fluid

33
Q

What are 3 additional structures in the foetal circulation?

A

Ductus arteriosus
Ductus venosus
Foramen ovale

34
Q

Via which vessel does oxygenated blood get from the placenta to the foetus?

A

Umbilical vein

35
Q

What’s the normal foetal heart rate?

A

110-160 bpm

36
Q

How can you monitor foetal cardiovascular system?

A

Umbilical artery flow Doppler

37
Q

What’s a cardiotocography?

A

Technique to record foetal heartbeat and uterine contractions during pregnancy

38
Q

How does foetal circulatory system adapt after birth?

A

Onset of breathing as pulmonary vascular resistance decreases

Increased blood flow to the lungs increases volume of pulmonary venous blood returning to the left atrium so left atrial pressure exceeds right atrial pressure = foramen ovale closure

Ductus arteriosus constricts as flow through pulmonary circulation increases and O2 tensions rise

39
Q

What causes the ductus arteriosus to close and when?

A

Within 1 day postnatal

Due to constriction of ductus arteriosus (as O2 tensions rise due to increased flow through pulmonary circulation)

(Ductus venosus closes within 2-3 months after birth)

B5 (20 decks)

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