Oral assessment prep Flashcards
What does HELLP stand for?
Haemolysed Elevated Liver enzymes Low Platelet syndrome.
When do you have the CFTS?
9 - 13+6 weeks (EO-PE 11-13+6 weeks)
When do you have the 2TMSS?
14-20+6 weeks
What trisomy does 2TMSS not screen for?
13
What does 2TMSS screen for that CFTS does not?
Neural tube defects.
When is the NIPT test conducted?
From 10 weeks.
When is a Morphology scan?
18-20 weeks
What is essential HTN?
HTN that is present before 20 weeks.
How is PIH diagnosed?
2 high BPs taken after 20 weeks. Resolves after pregnancy.
Why does PIH occur?
The expanding blood volume results in a higher blood pressure.
How is PE diagnosed?
HTN + proteinuria.
What are the symptoms of PE?
Headache, oedema, blurred vision, upper gastric pain, low urine output.
What tests do you do when someone presents with signs of PE?
BP (every 30mins), FBE, U&E, Coagulation factors, uric acid, LFTs, RFTs, urinalysis for urine PCR. Check fetal wellbeing.
What is the treatment for PE?
Antihypertensives to manage BP. Beta blockers and CCB.
What is used in labour to prevent seizures due to PE?
Magnesium Sulphate.
What is the difference between PE and HELLP?
HELLP may not have proteinuria. HELLP has high LFTS, vomiting, haematuria
What does DIC stand for?
Disseminated Intravascular Coagulation.
What is DIC?
A secondary condition that causes damage to the inside of vessels. The body’s clotting factors are depleted resulting in a loss of ability to clot.
What can cause DIC?
- PPH
- PE
- FDIU (sepsis)
- Placental abruption
- Amniotic air embolism
What are some symptoms of DIC?
- Bleeding from mucous membranes
- Hypotensive
- Tachycardia
- Febrile
- Malaise, unwell feeling
What tests are used to diagnose GDM?
OGTT and HbAIc+fasting blood sugar
How much glucose is given during a OGTT?
75g
What are the parameters to diagnose GDM for OGTT?
Fasting >5.0
1 hour >9.9
2 hours >8.5
What is chicken pox?
Varicella Zoster Virus.
What information does a woman who is diagnosed with GDM need?
- frequent appointments (midwives, OB, endocrinologist)
- Information on diet and exercise
- GDM may cause a baby to be bigger which means more frequent scans.
How can GDM affect the PN period?
- AN expressed colostrum can be useful to keep baby’s BGL level
- Skin to skin and lots of breastfeeding regulates baby’s levels
- GDM baby’s have higher rates of SCU admission.
- Both mum and baby will need 3 good BGLs before discharge.
How early can someone start expressing colostrum?
36 weeks.
How do you explain how GDM occurs?
Hormones that are produced during pregnancy act on the same receptors as insulin. This means that, even though insulin is being produced, because the receptors are being taken up by other hormones it is unable to have its effect.
This is why sugar intake should be reduced to not overwhelm what little insulin is able to be used and to reduce the amount of sugar going to baby.
What are the various methods of IOL?
Cervical ripening - Cooks balloon catheter, Prostin and Cervidil.
ARM
Syntocinon infusion
What is the required bishop score to perform an ARM?
7+
What does IOL increase the risk of?
- Cascade of intervention
- increased risk of instrumental birth
- increased risk of C/S
- Can interfere with breastfeeding and bonding
What is the difference in presentation between Placenta Praevia and Placental Abruption?
PP is not painful.
PA is painful and stomach is tight and extremely painful.