Medical Problems in Pregnancy Flashcards
If a woman (reproductive age) is known to have a medical problem, what do you want to do?
Discuss if she is planning family?
What contraception she is using?
Review her medication list .
Refer for preconception counselling if essential.
Advice to start folic acid! ( either 400mcg or 5mg)
why is folic acid given to women trying to conceive/ or pregnant women?
lack of folic acid can result in neural tube defects such as spina bifida
which couples are at high risk of conceiving a child with an NTD?
Either partner has an NTD, they have had a previous pregnancy affected by an NTD, or they have a family history of an NTD.
The woman is taking anti–epileptic medication.
The woman has coeliac disease or other malabsorption state,diabetes mellitus,sickle cell anaemia,or thalassaemia.
The woman is obese (defined as a body mass index [BMI] of 30 kg/m2or more).
how much folic acid should women take if they are at a normal risk, and high risk for neural tube defects
How long into their pregnancy should they take it for for each risk category?
Normal risk for an NTD: folic acid 400micrograms daily, to continue until the 12th week of pregnancy.
High risk of an NTDto take folic acid 5mg daily , to continue until the 12th week of pregnancy.
how much Folic acid should women with sickle-cell disease, thalassaemia, or thalassaemia trait take folic acid and for how long?
Women with sickle cell disease, thalassaemia, or thalassaemia traitshould takefolic acid 5 mg dailythroughout pregnancy
starting pregnancy at a healthy weight reduces the risk of….. and ……….
it can also result in less risk of
1) F
2) P
3) D
4) C
5) H
….diabetes and …….high blood pressure
fetal growth anomalies preterm birth death in the womb caesarean section haemorrhage after delivery.
Taking folic acid no less than 3 month before getting pregnant could prevent most cases of neural tube defects,such as Spina Bifida, by up to …..%
70
Stopping smoking before pregnancy can reduce the risk of….
1) E……… Pregnancy
2) M
3) B…….. Defects
4) D…… in the womb
5) P………. A……….
6) L…… B…… W……
7) Pre….. B…….
ectopic pregnancy miscarriage birth defects death in the womb placental abruption low birth weight preterm birth.
Alcohol consumption during pregnancy can cause what?
Fetal alcohol syndrome
Drug exposure, including prescribed painkillers during pregnancy increase the risk of what two things?
Neonatal Abstinence Syndrome
Sudden Infant Death.
What key 5 factors should you discuss with the patient before trying to conceive?
Healthy Weight
Folic acid
Quit smoking
Alcohol and drugs
Nutrition and Anaemia
During pregnancy and labour pre-existing medical conditions may worsen
Is this true or false
True
Chronic diseases and the treatment can impact fetal growth, health and development
Is this true or false
True
How is asthma treated uncontrolled during pregnancy?
No/little modification in medication as benefits outweigh the drawbacks.
Steroids should be used as needed in the usual way and not withheld due to pregnancy
How are couples that are both carriers of the cystic fibrosis gene managed throughout pregnancy?
Preconception counselling and planned pregnancy
Maternal nutrition
control of pulmonary infection
avoidance of hypoxia
fetal surveillance.
Multidiscliplinary management.
why may aspirin be given to women during pregnancy?
women who are at high risk off pre-eclampsia
how much aspirin is recommend to women with a high risk of pre-eclampsia?
150mg of aspirin
from what time frame do women with a high risk of pre-eclampsia during pregnancy start taking aspirin and when do they stop?
how often do they take the aspirin?
from 12weeks
until the birth of the baby
daily
Which women are at high risk of developing pre-eclampsia during pregnancy
women with the following;
hypertensive disease during a previous pregnancy
chronic kidney disease
autoimmune disease such as systemic lupus erythematosus or antiphospholipid syndrome
type1 or type2 diabetes
chronic hypertension.
which women are at moderate risk of developing pre-eclampsia?
women who;
first pregnancy
age 40years or older
pregnancy interval of more than 10years
PCOS
body mass index (BMI) of 35kg/m2or more at first visit
family history of pre-eclampsia
multi-fetal pregnancy.
do you advise pregnant women with 1or more moderate risk factor for pre-eclampsia to take aspirin?
how much would you recommend she take and how often?
specify the duration of how long she will have to take aspirin?
YES
take 150mg of aspirin
daily
from 12weeks until the birth of the baby.
List the diabetic support measures for a pregnant women?
routine blood tests are carried out to check HbA1c level - target below 48 mmol/mol
Individualised targets for self-monitoring of blood glucose should be agreed, taking into account risk of hypoglycaemia
Metformin can be used as an adjunct or alternative to insulin in those with type 2 diabetes but other oral hypoglycaemics should be discontinued prior to pregnancy
Many with type 2 diabetes will be converted to insulin during this period.
list the support measures put in place for a diabetic women trying to conceive?
Planned pregnancy is recommended
Blood glucose targets, monitoring and control should be discussed prior to pregnancy.
Many with type 2 diabetes will be converted to insulin during this period.
what should be recommended to a diabetic women trying to conceive who has a HbA1c of more than 86 mmol/mol
should avoid pregnancy until better control has been established.
