Maternal wellbeing (review) Foetal development and wellbeing ….as the foetus grows and develops Flashcards
What does preconceptial care include?
When is the embryo at most risk?
Identifying potential enviromental toxin exposure in women and men along with avoidance advice
Embryo is most at risk when women dont know theyre pregnant.3-14/40 most susceptible period
What is the difference between structural and functional abnormalities ?
Structural abnormality = problem with body parts i.e cleft lip, NTD
Functional abnormality= how a body part or system works i.e developmental disabilities
What can anti-epileptic drugs do to the embryo?
Cleft lip and palate
What can rubella do to the developing foetus?
20% risk if contracted during early pregnancy = cataracts; heart defects; mental retardation
What foods must you avoid when pregnant? What is the risk associated with them?
mould-ripened soft cheeses & blue-veined cheese due to listeria bacterium and associated risks of miscarriage, stillbirth and sick neonate
What can toxoplasmosis cause? Where is it found?
can cause miscarrage; found in soil; don’t change the cat litter!
What particualr histories do you need obtain in a pregnant woman?
CVS/Blood : Hx of CVS disease; BP; Iron; Anaemia; Hx of thrombosis; Travel advice; Regular blood tests
Respiratory: Hx of respiratory disease; smoking
Urinary/Renal: Hx of renal disease; urinalysis; BP; Bloods; oedema
Glucose metabolism: Risk assessment; weight; nutrition; exercise; screening for GDM
How often does hyperemesis gravidarum in pregnancies?
3.6 % of pregnancies
How long does frequent micturition occur in pregnancies? Why does it occur?
Frequency of micturition due to the vascularity of the bladder and lasts until about 16/40 when the gravid uterus rises out of the pelvic girdle
What is gravidity?
the total number of pregnancies including the current one if pregnant (gravidity would count as 1 with twins)
What is parity?
the number of livebirths or stillbirths after 24 weeks gestation (Parity would count as 2)
How many births are premature?
up to 10%
What are the reasons of most still births?
Most remain unexplained but there does seem to be a link to IUGR/Foetal Growth Restriction (FGR)
how can you assist in looking after the foetus?
Monitor growth to identify intrauterine growth restriction
Identify anomalies
What is classed as a small, average and large baby?
What is classed as a premature baby?
37 weeks.
But there are different categories levels of prematurity and these carry their own risks:
- Extremely preterm (less than 28 weeks)
- Very preterm (28 to 32 weeks)
- Moderate to late preterm (32 to 37 weeks)
What can we do if there is a risk of prematurity? explain why
Magnesium sulphate as it is neuroprotectant to reduce the risk of cerebral palsy
Steriods- it stimulates the sythesis of surfactant which lubricates the lungs and allows the air sacs to glide against each other without sticking;
prevent bleeding in the brain (6 of 100 babies);
lower risk of necrotizing enterocolitis (4 of 100 babies)
24-34 weeks (double dose 24 hours apart)
34-37 weeks (single dose)
What do biometric tests do?
They are designed to predict foetal size at a point in gestation. If performed periodically can indicate growth but not foetal well being.
What do biophysical tests do?
(Doppler / liquor assessment) can predict foetal well being but not growth
What biometric parameters do you use in the second trimester scan?
Biparietal diameter (BPD)
Head circumference (HC)
Abdominal Circumference (AC)
Femur Length (FL)
What are the risk assosciated with interuterine growth restriction babies?
Risks: Stillbirth
Low birth weight (LBW)
Decreased O2 levels
Hypoglycaemia
Hypothermia
Less resistant to infection
Difficulty handling vaginal delivery
How is the placenta doing?
