Module 4 Women's Health Flashcards
What is a Braxton-Hicks contraction?
Irregular uterine contraction, not associated with labour
Name for stretch marks
Straie Gravidarum
Name for morning sickness
Hyperemesis gravidarum
Hyperemesis Gravidarum treatment and complications
Pyridoxine or metoclopramide
Psychotherapy
Anaemia, hyponatraemia, kidney failure PTSD VTE PE Depression Lower infant birth weight Premature labour
Pre-eclampsia cause
Abnormal formation of blood vessels in the placenta - leading to inflammatory reaction
Pre-eclampsia definition
20 weeks, new onset, 140/90 HTN, Proteinuria, resolves after pregnancy
Name of milk precursor
Colostrum
What is Chadwick’s sign
vaginal/cervical cyanosis
Hegar’s sign
Palpable softening of the Cervical Isthmus
What is the white vaginal discharge of pregnancy called?
Leukorrhea
How to calculate due date?
Naegele’s rule:
LMP +7 days
-3 months
+1 year
maternal nutrition
30 mg iron a day
0.4-0.8 mg folic acid a day
Normal weight gain in first trimester
5%
How many additional calories needed by mother
300 calories extra per day
Comparison between GHTN, Pre-eclampsia and chronic hypertension…
GHTM is >140/90 after 20 weeks
Pre-eclampsia is >140/90, after 20 weeks with proteinuria
Chronic HTN is >140/90before pregnancy, before 20 weeks oand after 12 weeks
What is peripartum cardiomyopathy
Peripartum cardiomyopathy is a weakness of the heart muscle that by definition begins sometime during the final month of pregnancy through about five months after delivery, without any other known cause. Most commonly, it occurs right after delivery. It is a rare condition that can carry mild or severe symptoms
Fundus measuring principles
Should be measured if over 20 weeks
At 20 weeks should reach umbilicus
in 16-36 weeks, length should match age in weeks
If 4 cm too long consider twin pregnancy, polyhydramnios, large fetus, uterine myoma
If 4cm too short, consider oligohydrosis, missed abortion, IUGR, fetal anomaly
GP system
TPAL Term deliveries Preterm deliveries Abortions Living children Ga,Pbcde
Normal folic acid dose
400 micrograms
Who should have 5mg folic acid
Women with diabetes
Higher doses also needed for high BMI patients, patients on anti-epileptics, women with previous neural defect pregnancies
A prescription is needed
Most common nutrient deficiency in pregnancy?
How is it identified?
Iron
Look at FBC, MCV
Ferritin drops in pregnancy anyway
There is physiological anaemia due to increased blood volume anyway.
When is pre-eclampsia more common?
Primigravid, older patients, multiple pregnancy
Is prednisolone safe in breast feeding?
Yes after 1st trimester
Steroid given for fetus
Dexamethasone is given as metabolised by placenta
Risk factors of obstetric cholestasis
Fetal size
Obesity
Multiple pregnancy
Manage anxiety, increased risk of still birth
Treat with ursodeoxycholic acid
obstetric cholestasis sign
Itching with no rash
Commonest cause of pregnancy related maternal mortality in the uk
Sepsis
Indirect cause - CVD
Principles of HIV management in pregnancy
Screening
No breast feeding
if low viral load, vaginal birth can happen, if not then c-section
Anti-emetics to use in hyperemesis
Cyclozine
hydrocortisone
Metoclopramide
Risks of diabetes in pregnancy
3/4 x risk increase for fetal abnormalities
When to worry about maternal heart murmur
Overseas patients
Diastolic murmur - RH overload
