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PMMH > Maternity > Flashcards

Maternity Flashcards

1
Q

S&S IN PREGNANCY

A
  • N & V: Usually stops after 1st trimester but some women experience it longer due to HCG levels
  • Increased urination
  • Back pain
  • Striae Gravidarium (stretch marks)
  • Linea Nigra- line going down from sternum
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2
Q

Implantation bleeding

A
  • not all bleeding is bad!
  • After implantation, bleeding usually occurs 5-12 days after fertilisation
  • Any clots? How big?
  • Usually lasts 1-2 days
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3
Q

Pseudo pregnancy

A
  • Phantom pregnancy
  • No real know cause for it
  • Very rare
  • Abdomen usually distends and breasts secrete a cloudy liquid
  • MH
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4
Q

Pregnancy notes:

A
  • Document everything
  • Safe and effective practice
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5
Q

MEOWS

A
  • Maternity NEWS2 score
  • Consider sepsis in pregnant/ postpartum pts
  • Early warning tool
  • Find out what’s normal for them
  • In hospital, lochia & urinalysis forms part of the assessment!
  • Values differ due to physiological adaptations in pregnancy
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6
Q

Back Pain

A
  • Common
  • Advise paracetamol and if so severe, refer to GP
  • Waddling gait caused by increase in relaxin which increases pelvic laxity (movement)
  • Increased abdominal weight leads to a shift
    In the centre of gravity and a tenderness
  • Stretched abdominal muscles lose their ability to maintain posture, therefore the lower back has to support majority of the weight
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7
Q

Braxton hicks

A
  • Irregular contractions, moving/resting/changing position may stop braxton hicks!
  • “Practice contractions”
  • Uncomfortable, not as painful as labour contractions, weaker rather than stronger- debatable
  • It doesn’t follow a regular pattern like labour does and doesn’t come closer together like it does in labour.
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8
Q

Gastric reflux

A
  • Increase in progesterone loosens everything up and pressure from the uterus shoves everything up and it feels like you’re breathing fire!
  • Refer to GP
  • Increase in progesterone causes the smooth muscle of the stomach to relax into the oesophagus causing heartburn.
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9
Q

DVT

A
  • Pregnancy increases risk by 5-10 times, not that common though.
  • Level of blood clotting proteins increases & anticlotting protein level decreases.
  • Swelling, Redness, heat, painful leg
  • They will receive a D dimer test, ultrasound
  • They may be given heparin which does not cross through to the placenta
  • Enlarged vein puts uterus in additional pressure
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10
Q

Varicose veins

A
  • Occurs when valves in the veins weaken from an increase in progesterone, circulatory volume and weight of growing baby, placenta & uterus causing blood to pool!
  • May be the result of hormonal changes
  • Skin thins over the veins so haemorrhage easily and often hard to stop!
  • Discomfort, swelling , muscle cramps especially at night, burning or throbbing legs
  • Are they on blood thinners?
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11
Q

Examination in hospital

A
  • Internal examination in under 8 weeks pregs
  • Visualisation via ultrasound
  • Pinnard steth used to auscultate fetal heart
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12
Q

Growing pains

A
  • Round ligaments in the lower abdomen get stretched by the growing uterus
  • Sharp, achy sensations on one or both sides of the lower back
  • Usually felt around 14 weeks but can be anytime from the second trimester onwards.
  • RED FLAG- severe pain with NO fetal movement, assume placental abruption until proven otherwise
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13
Q

Braxton hicks vs Labour contractions

A
  1. Braxton:
    - Practice contractions
    - Irregular, don’t come close together as time goes on
    - Moving, resting or changing position will stop Braxton hicks

Labour:
- regular contractions, lasting 30-60secs
- Contractions increase in frequency and power

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14
Q

Pulmonary embolism

A

-Occurs because:
- pts are not moving as much,
- more clotting tendency to prevent blood loss during childbirth puts mum at greater risk of clots
- Limited mobility: Especially in the later stages, less movement increases blood stasis
- Reduced blood flow as the uterus grows and compresses on blood vessels, it may reduce blood flow to the heart and lungs.

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15
Q

Haemorrhoids

A
  • Dilated veins in the anal canal
  • May become very painful, bleed or become infected
  • Increased risk of constipation due to decrease in gastric motility
  • Chronic constipation may lead to it
  • Iron supplements
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16
Q

Anaemia

A
  • Increase in blood during pregnancy which dilates red blood cells
  • Look at conjunctiva, perfusion, energy levels, breathlessness (exertional?), palpitations
  • When the body doesn’t have enough healthy red blood cells/ haemoglobin to carry adequate oxygen to tissues and organs
17
Q

Gestational diabetes

A
  • Risk: Worried about a large baby, premature birth, excessive amniotic fluid, can make eclampsia and preeclampsia more likely!!
  • May also cause still birth
  • May present with hyperglycaemia symptoms
18
Q

Pregnancy induced hypertension

A
  • Persistently elevated BP-140/90 after 20 weeks gestation
  • Complications: Blood vessel damage, decreased blood flow to the uterus
    Preeclampsia s&s: Headache, visual disturbances, seizures, chest pain, dizziness, swelling (face and hands)
19
Q

Morning sickness

A
  • Offer antiemetics through GP referral if so severe
20
Q

Hyperemesis gravidarium

A
  • Associated with dehydration, weight loss, postural hypotension, tachycardia, ketosis, electrolyte imbalance
  • Requires hospital treatment- fluids & antiemetics
  • Foetus is at risk of being small due to lack of nutrients
21
Q

UTI

A
  • Group b streptococcus can infect baby and be fatal
  • Bladder capacity is compromised by growing uterus
22
Q

Thrush

A
  • Babies can develop oral or genital thrush due to vaginal birth.
  • Babies can get oral thrush as they don’t have a developed immune system yet
  • When mum is breast feeding, the baby may give it to mother and breastfeeding may be really painful leading to cessation
  • Treated with cream
  • PH changes and increased glycogen content make pregnant women more susceptible to thrush!
23
Q

Miscarriage

A
  • Loss of pregnancy before 24 weeks. Most common in the first 12 weeks
  • Diagnosis is made in hospital with an ultrasound
    Cervical shock- decomponsated shock, bradycardia
24
Q

Termination pains

A
  • Medical or surgical
  • Likely to feel discomfort and bleed pV for up to a fortnight (14 days to a month)
  • Ibuprofen for the pain and sanitary pads for bleeding not tampons
25
Q

FGM

A
  • Scar tissue does not stretch like normal tissue
26
Q

Mastitis

A
  • Inflammation of the breast , usually in breast feeding women
  • Most efficient way is to continue breast feeding as the baby is the best to get this out!
  • May cause tachycardia, pyrexia and rigor
27
Q

Post partum depression

A
  • Suicide is a direct cause of maternal death
  • Baby blues last usually 6 weeks:/
28
Q

Domestic abuse

A
  • 15% of women report violence during their pregnancy
  • Over a 3rd of domestic violence starts or gets worse during pregnancy

PMMH (12 decks)

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