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Haematology > obstetric haematology > Flashcards

obstetric haematology Flashcards

1
Q

describe the 4 chains in normal haemoglobin

A

2 alpha chains and 2 non-alpha chains

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2
Q

describe the 4 chains in normal haemoglobin

A

2 alpha chains and 2 non-alpha chains

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3
Q

what is the role of globin in haemoglobin

A

protects haem from oxidation
renders the molecule soluble
permits variation in oxygen affinity

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4
Q

what is the percentage of Hb-A in normal adult /hb

A

> 95%

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5
Q

what is the percentage of Hb-A2 in normal adult Hb

A
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6
Q

which testing is offered to high risk pregnancies following antenatal screening?

A

chorionic villus biopsy and genetic diagnosis at 8-12 weeks

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7
Q

how does pregnancy affect the RBC MCV

A

MCV increases physiologically
pregnancy increased folic acid requirements
iron requirements increase but this usually results in considerable mobilisation of iron stores

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8
Q

what happens to the plasma volume in pregnancy

A

plasma volume expands by 50%

haemodilution occurs maximally at 32 weeks

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9
Q

how much does the RCM expand in pregnancy

A

25%

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10
Q

define anaemia in the 1st and 3rd trimester

A

Hb

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11
Q

define anaemia in the 2nd trimester

A

Hb

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12
Q

what is the most common cause of anaemia in pregnancy

A

iron deficiency

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13
Q

what happens to WBC count in pregnancy

A

leucocytosis (increase in WBCs)

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14
Q

which WBC increases in number the most

A

neutrophilia

peak range around 9-15 in 2nd-3rd trimester

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15
Q

describe the left shift that may be seen

A

myelocytes/ metamyelocytes

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16
Q

what happens to the platelet count in pregnancy

A

thrombocytopenia

usually >70x109/L

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17
Q

when does the platelet count fall and when is thrombocytopenia most marked?

A

after 20 weeks starts to fall

most marked in late pregnancy

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18
Q

what is the effect of thrombocytopenia

A

no pathological significance for mother or foetus
recovers rapidly following delivery
main issue in management is differentiation from other causes

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19
Q

what are the consumptive causes of pregnancy associated thrombocytopenia

A 
gestational
pre-eclampsia and HELLP syndrome
AFLP
DIC 
TTP/HUS
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20
Q

what are the consumptive causes of pregnancy associated thrombocytopenia

A 
gestational
pre-eclampsia and HELLP syndrome
AFLP
DIC 
TTP/HUS
21
Q

what are the coincidental consumptive causes of thrombocytopenia

A 
ITP
viral (HIV/ EBV)
sepsis
type 2B vWD
hypersplenism
22
Q

what is the percentage of Hb-A in normal adult /hb

A

> 95%

23
Q

what is the percentage of Hb-F in normal adult Hb

A
24
Q

which testing is offered to high risk pregnancies following antenatal screening?

A

chorionic villus biopsy and genetic diagnosis at 8-12 weeks

25
Q

how does pregnancy affect the RBC MCV

A

MCV increases physiologically
pregnancy increased folic acid requirements
iron requirements increase but this usually results in considerable mobilisation of iron stores

26
Q

what happens to the plasma volume in pregnancy

A

plasma volume expands by 50%

haemodilution occurs maximally at 32 weeks

27
Q

how much does the RCM expand in pregnancy

A

25%

28
Q

define anaemia in the 1st trimester

A

Hb

29
Q

define anaemia in the 2nd trimester

A

Hb

30
Q

what is the most common cause of anaemia in pregnancy

A

iron deficiency

31
Q

what happens to WBC count in pregnancy

A

leucocytosis (increase in WBCs)

32
Q

which WBC increases in number the most

A

neutrophilia

peak range around 9-15 in 2nd-3rd trimester

33
Q

describe the left shift that may be seen

A

myelocytes/ metamyelocytes

34
Q

what happens to the platelet count in pregnancy

A

thrombocytopenia

usually >70x109/L

35
Q

when does the platelet count fall and when is thrombocytopenia most marked?

A

after 20 weeks starts to fall

most marked in late pregnancy

36
Q

what is the effect of thrombocytopenia

A

no pathological significance for mother or foetus
recovers rapidly following delivery
main issue in management is differentiation from other causes

37
Q

what are the pregnancy associated production causes of thrombocytopenia

A

production failure due to severe folate deficiency

38
Q

what are the consumptive causes of pregnancy associated thrombocytopenia

A 
gestational
pre-eclampsia and HELLP syndrome
AFLP
DIC 
TTP/HUS
39
Q

what is the productive coincidental cause of thrombocytopenia

A

bone marrow infiltration/ hypoplasia

40
Q

what are the coincidental consumptive causes of thrombocytopenia

A 
ITP
viral (HIV/ EBV)
sepsis
type 2B vWD
hypersplenism
41
Q

what happens to coagulation in pregnancy

A

pregnancy is a pro-thrombotic state

42
Q

what happens to platelet activation

A

increases in pregnancy

43
Q

what happens to coagulation factors

A

increase in many procoagulant factors

reduction in some natural anticoagulants

44
Q

is there an increase of decrease in fibrinolysis

A

decrease

45
Q

which coagulation factors are increased

A

fibrinogen, thrombin, factor V, VIII, X, XII

46
Q

what happens to the level of vWF

A

great increase in vWF than FVIII

47
Q

how do levels of FIX and FXI change

A

minimal increase in FIX and decrease in FXI

48
Q

how does FXIII change

A

initial increase followed by reduction to approx. 50% non pregnant value

Haematology (5 decks)

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