Maternal & Foetal Wellbeing Flashcards
(41 cards)
When is the embryo most at risk?
When women dont know they are pregnant at 3-14 weeks when all major organ systems are developing
What are the different types of abnormalities that occur in babies?
Structural: production of a congenital malformation by a teratogen causing problem with body parts i.e. cleft lip, NTD
Functional: direct toxic effect on cells of embryo either lethal or reduction in growth - how a body part or system works i.e. developmental disabilities
What are the common causes of abnormalities?
Alcohol: FAS and heart defects
Folic acid deficiency: NTD
Anti-epileptic drugs: cleft lip and palate
Rubella: cataracts, heart defects and mental retardation
Foods: mould-riped soft cheese/ blue-veined cheese due to listeria bacterium - risks of miscarriage, still birth and sick neonate
Toxoplasmosis: in soil and cat litter - miscarriage
What are the common symptoms in the first trimester in pregnancy?
Morning sickness due to rising hCG levels (hyperemesis gravidarum)
Frequency of micturition due to bladder vascularity and lasts until 16/40 when gravid uterus rises out of pelvic girdle
What are the common symptoms later on in pregnancy?
Peridontal disease
Heartburn (by third trimester 80%)
Constipation (rising progesterone = reduced motility)
Haemorrhoids
Leucorrhoea (white/non-irritant/offensive)
Hyperpigmentation of skin of areola, nipples, vulva and perianal region
Backache (loosening of ligaments and altered maternal posture)
Symphysis pubis dysfunction
Leg cramp
CTS + oedema
What should be included in an obstetric history?
Gravidity and parity
Define gravidity.
The total no. of pregnancies including the current one if pregnancy (1 even if the women is having twins)
Define parity.
The number of livebirths or stillbirths after 24 weeks gestation (twins = 1)
What is stillbirth related to?
Mostly unexplained but there is a link to IUGR/foetal growth restriction (FGR, obesity and smoking
How do you listen to the babies heart rate?
Pinnard stethoscopes
What is a normal and abnormal birth weight?
Average = 3.2kg Small = <2.5kg Large = >4.5kg
What is prematurity?
Baby born before 37 weeks
Extremely: < 28 weeks
Very: 28-32 weeks
Moderate-late: 32-37 weeks
What can be done if there is a risk of prematurity?
Double dose 24 hours apart at 24-34 weeks and single dose at 34-27 weeks:
- Magnesium sulphate: neuroprotectant to reduce cerebral palsy risk
- Steroids e.g. Beclomethasone: stimulates surfactant synthesis to lubricate the lungs allowing air sacs to glide against eachother w/o sticking preventing bleeding in the brain and necrotizing enterocolitis
What happens the higher the gestational age goes of a baby?
Increased risk of perinatal mortality
What are biometric tests?
Designed to predict foetal size at a point in gestation - if performed periodically can indicate growth but not foetal well being
What are biophysical tests?
Doppler/liquor assessment can predict foetal wellbeing but not growth
What are the foetal biometric parameters in the 1st trimester?
CRL - used in early pregnancy due to little biological variability (6-13 weeks)
What are the foetal biometric parameters in the 2nd trimester?
Biparietal diameter (BPD) Head circumference (HC) Abdominal circumference (AC) Femur length (FL)
What is intra-uterine growth restriction (IUGR)/foetal growth restriction (FGR)?
Small for gestational age of baby - below 10%
What are the risks of intra-uterine growth restriction (IUGR)/foetal growth restriction (FGR)?
Tachycardia in 50% of cases Stillbirth LBW Decreased O2 levels Hypoglycaemia Hypothermia Less resistant to infection Difficulty handling vaginal delivery Placental problems
What are the different types of intra-uterine growth restriction (IUGR)/foetal growth restriction (FGR)?
- All foetal biometrics less than expected usually presenting early as a result of infection or chromosome abnormalities
- Disproportion between diameters, AC is classically affected and there is foetal head sparing due to increased brain to liver ratio as a result of placental insufficiency or pre-eclampsia
What is a sign that intra-uterine growth restriction (IUGR)/foetal growth restriction (FGR) is really severe?
Foetal head circumference decreasing
What is biophysical profiling (BPP)?
Test in the 3rd trimester that combines a non-stress test with US to check the health of the foetus that measures:
- HR in response to foetal movements
- Breathing
- Movements
- Tone
- Amniotic fluid volume
How is amniotic fluid volume regulated?
By swallowing at 10-12 weeks which causes the stomach and SI to produce HCL and digestive enzymes so there is movement of fluid in the GI which may enhance growth and development of the GI tract
